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Country Update: Tuberculosis in Thailand Dr. Chawetsan Namwat NTP manager and Director of BTB, DDC, MOPH, Thailand 1.

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Presentation on theme: "Country Update: Tuberculosis in Thailand Dr. Chawetsan Namwat NTP manager and Director of BTB, DDC, MOPH, Thailand 1."— Presentation transcript:

1 Country Update: Tuberculosis in Thailand Dr. Chawetsan Namwat NTP manager and Director of BTB, DDC, MOPH, Thailand 1

2 TB prevalence in high burden countries 2 Source: WHO, Global TB report, 2012

3 Tuberculosis situation 3 source: WHO, Global Tuberculosis Report 2012

4 TB incidence (per 100,000) by WHO region, and in Thailand, 2011 source: WHO, Global Tuberculosis Report 2012 TB incidence in Thailand is 2.5 – 4 times higher than Europe & America regions

5 Thailand: Estimated TB incidence rates, Trends in estimated TB incidence rates (green) and estimated incidence rates of HIV-positive TB (red). source: WHO, Global Tuberculosis Report 2012

6 Trend of New smear-positive (New M+) case notification by all types of TB in Thailand, 2001 -2012 BTB-Updated : May 28, 2013

7 Treatment outcome, 2001-2011 BTB-Updated : May 28, 2013

8 Treatment outcome, 2001-2011 BTB-Updated : May 28, 2013

9 Missing < 80% 80%-84% 85%-89% ≥ 90% < 5% 5%-10% > 10% < 1% 1%-2% ≥ 3% Treatment outcome, 2011 BTB-Updated : May 28, 2013

10 Estimates of MDR-TB burden (2011),Thailand Estimates among notified cases % of new TB cases with MDR-TB1.7 (1.0–2.6) % of retreatment TB cases with MDR-TB35 (28–42) Estimated MDR-TB cases among new pulmonary TB cases notified in 2010 890 (540–1 400) Estimated MDR-TB cases among retreated pulmonary TB cases notified in 2010 1 300 (1 000–1 600) Source: WHO Global TB Report 2012

11 MDR TB in High Burden Countries and Thailand Sources: WHO, Global TB Report 2012 and Bureau of Tuberculosis, DDC, MOPH, Thailand

12 MDR TB in High Burden Countries and Thailand Sources: WHO, Global TB Report 2012 and Bureau of Tuberculosis, DDC, MOPH, Thailand

13 Percentage of new TB cases with MDR-TB

14 MDR TB in High Burden Countries and Thailand Sources: WHO, Global TB Report 2012 and Bureau of Tuberculosis, DDC, MOPH, Thailand

15 Percentage of previously treated TB cases with MDR-TB

16 Drug resistance surveillance 2012 (prelim) 16

17 National TB Prevalence Survey, 2012  Principal Investigator: Dr Sriprapa Nateniyom  Multi-stage cluster sampling  100 clusters x 900 subjects = 90,000 subjects  BKK 17 clusters, Non-BKK 83 clusters  Study Population  age 15+ years  At least 14 days resided in the survey area  Interview and CXR all subjects sputum smear & culture for all suspects 17

18  83 clusters in non-BKK  61,651 participants (M=27,478; F=34,173)  142 culture-confirmed TB cases (M=98, F=44)  Age: 44% age 60+yr.  Smear+ 41%, Smear- 59%  Symptom & CXR  Symptom+ 35% (Symptom score 3+)  CXR abnormal, no symptom 65% PRELIMINARY RESULT. NOT FOR REFERENCE 18 Prelim. Result: National TB Prevalence Survey, 2012 (Non-BKK)

19 Participation by age group 19 Number PRELIMINARY RESULT. NOT FOR REFERENCE Prelim. Result: National TB Prevalence Survey, 2012 (Non-BKK)

20 Age distribution of TB cases(N=142) PRELIMINARY RESULT. NOT FOR REFERENCE 20 Prelim. Result: National TB Prevalence Survey, 2012 (Non-BKK)

21 Age distribution of smear+ PTB, Report.506 Source: R506: Pulm TB New M+ /2008-2011, BOE

22 Age distribution of smear+ PTB, Report.506 22

23 Challenge when the AEC starts Incidence rate (per 100,000) AEC 2015 23

24 TB control in Thailand  Align with global stop TB strategy  “Zero and Five to minimize MDR-TB”  ค้นให้พบ จบด้วยหาย ตายน้อยกว่าร้อยละ 5 ขาดยาเป็น 0  Political commitment & Universal coverage scheme 24

25 Plan for DR-TB  Magnitude of problem  DRS 2012 : MDR: 1.8% among new TB, 17% among retreatment TB  Case detection  C/ DST : Re – On – Pre  Network of lab 25

26 Plan for DR-TB  Treatment & Patient Support  Guideline & Training  MDR-TB treatment center (general & regional hospitals) – NHSO approved  Consultation mechanism  Lab for f/u  R&R – paper & electronic  DOT 26

27 Plan for DR-TB  Specific issues for migrants:  Multi-country proposal : for GF support  Referral system at border area :  Health insurance for migrants: documented and non- documented migrant labors 27

28 28 Plan for DR-TB

29 29 Plan for DR-TB

30 ขอบคุณครับ 30


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