Lo YR, Liewsaree T, Fujita M, Kongsin S, Suebsaeng L, Guntamala L, Natpratan C; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePeC4435.
Y.-R. Lo, WHO Thailand, c/o Ministry of Public Health, Tiwanond Road, Nonthaburi 11000, Thailand, Tel.: +66 2 965 9283, Fax: +66 2 591 8199, E-mail: yingrulo@whothai.moph.go.th
Background: In 1998 HIV prevalence of 41 % among new TB cases was reported from northern Thailand. 33 hospitals have been offering IPT services for PLWH since 1994. One provincial hospital A and 5 district hospitals B - F were selected for assessment of IPT services. Data from 1998 are presented. The objectives of the assessment were to analyze reasons for successful implementation and key constraints in order to identify critical issues for improving IPT services. Description: Hospital A offered IPT from 1994 - 1997. Due to increase of new TB cases to 944 in 1998, IPT services were discontinued and resources shifted to DOTS. In hospital B 80% of enrolled PLWH completed IPT, which is offered as part of the care package for PLWH. The AIDS unit's day care center (DCC) is the entry point to IPT, offering repeated counseling for assessment of readiness, careful screening for TB and participation of PLWH groups. In hospital C, though accomplishing 67% completion rate (CR), 13 % died and 3 % developed active TB during IPT. IPT is offered at the AIDS unit's DCC by the TB unit with involvement of PLWH group. Inclusion criteria are unsatisfactory. Hospital D reported CR of 49 %. Due to prior CR of less than 30 % the hospital reoriented from targeting DCC clients to HIV positive mothers. Hospital E reported less than 50% CR, high default and death rate due to inadequate enrollment criteria. Hospital F reported CR of 40%. Death rate, default and failure exceed 50 % due to overburdened services and inadequate screening. Conclusions: Quality of IPT counseling, well organized DCC and involvement of PLWH groups are crucial for good adherence. Careful screening for TB and advanced HIV infection are critical for reduction of death rate and failure. IPT offered as part of the care package for PLWH does not distract resources from DOTS but prioritization of DOTS remains crucial. Focussing on specific target groups as HIV positive mothers is one option to target IPT service.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Counseling
- HIV
- HIV Infections
- HIV Seropositivity
- Humans
- Isoniazid
- Prevalence
- Research
- Thailand
- organization & administration
- prevention & control
Other ID:
UI: 102240701
From Meeting Abstracts