Welcome to
TB/HIV Research Foundation (THRF),
Chiang Rai, ThailandLocal Wisdom…Global Knowledge
The visit of the delegates from the European Parliamentary Forum on Population and
Development (EPF) and the International Advocacy Officer to THRF - 29 January 2011 Thailand.
04/19/23 2
• The Research Institute of Tuberculosis, Anti-
Tuberculosis Association (RIT/JATA)
•Double barred cross seal donation of Japan
• Japan Foundation for AIDS Prevention (JFAP)
• Stop TB Partnership (CFCS grant)
• The Mitsubishi Foundation
Acknowledgement
Presentation outline- Knowing THRF
- Knowing TB and TB/HIV
- Knowing Chiang Rai and situations of TB and TB/HIV in
Chiang Rai
- Challenges and opportunities for control TB and TB/HIV in Chiang Rai
- Empowering community and people with TB and TB/HIV * Patient volunteers": The important human resource for
TB/HIV care
* Center for Sharing: Mobilizing women volunteers to support poor patients
- Comments, recommendation and commitments from the delegates.
Knowing TB and TB/HIV
TB…one of the oldest diseases (>4,000 years)
In the old days TB was the disease of VIP
Chopin, Pianist, composer
Nelson Mandela, former-president, South Africa
Emperor Akihito
Japan
22 countries with high TB burden in the world.(WHO, 2009)
1. India2 - China
3.Indonesia4 - Nigeria
5 - South Africa6 - Bangladesh
7 - Ethiopia8 - Pakistan9.Philippines
10 - Democratic Republic of Congo11 - Russian Federation
12 - Viet Nam13 - Kenya14 - Brazil
15 - United Republic of Tanzania16. Uganda
17 - Zimbabwe18.Thailand
19 - Mozambique20.Myanmar
21 - Cambodia22 - Afghanistan
TB is transmitted by the tuberculosis patients who do not receive treatment
(when coughing, sneezing, spitting, speaking)
1 untreated TB case will infect approxi - pppppp ppppp pppp1 0 1 5
(an untreated (an untreated TB patients who have drug-resistant strain willTB patients who have drug-resistant strain will also transmit also transmit the resistant-the resistant- strain to others) strain to others)
A TB patient who does not receive TB treatment
-TB/HIV Research Project(RIT JATA) -TB/HIV Research Project(RIT JATA)
T he best way to prevent TB transmission is to cure TB patients
The Travelling of TB Germs… TB without border
TB/HIV Research Project (RIT-JATA)
TB is curable by using 4 drugs for 6-8 months
isoniazid, rifampicin, pyrazinamide, ethambutol.
http://www.textbookofbacteriology.net/tuberculosis_3.html
Why TB/HIV?• HIV is the most powerful known risk factor for reactivating latent TB infections into TB diseases
• TB is the leading cause of death in PLHIV
Not TB infected
Latent TB infection
Active TB
(disease)
HIV infection (70 - 113 times
risk)
Knowing Chiang Rai and situations of TB and
TB/HIV
04/19/23
• Population ~ 67 million (2010)
• Living with HIV ~ 610,000(2007)
• HIV adult prevalence 1.4%(2007)
• TB cases ~ 55,000 (2007)
• TB incidence ~ 142/100,000
• ranked 18th of the 22 high
burden countries (WHO 2010)
Map of Thailand 14
Chiang Rai ProvinceChiang Rai Province
Cambodia
Myanmar
China
Laos
Vietnam
Bangkok
Chiang Rai
• Population ~1.3 millionsPopulation ~1.3 millions• Areas 11,678 sq.kms.Areas 11,678 sq.kms. (~30% mountain/forest)(~30% mountain/forest)• 18 Districts18 Districts
Golden-TriangleGolden-Triangle
•Migrants from Myanmar and LaosMigrants from Myanmar and Laos
•Hill-tribe population : 13%Hill-tribe population : 13%
Laos
Myanmar
Thailand
04/19/23
0
500
1000
1500
2000
2500
HIV positive HIV negative HIV unknown16
Population ~ 1.3 million
Living with HIV 9922
TB notification rate 144/100,000 population
HIV positive in TB patients 46% in 1998
46%
TB/HIV Research Project (RIT-JATA)TB/HIV Research Project (RIT-JATA)
Number of reported TB cases among Thai, hilltribes and migrants in 2000-2009
Percentage of Thai, hilltribes and migrants TB patients who died during TB treatment in 2000-2009
Percentage of Thai, hilltribes and migrants TB patients who dropped out from TB treatment more than 2 moths in
2000-2009
Number of reported TB cases among male, female adults and children in 2000-2009
Number of reported among children TB cases in 2000-2009
Percentage of male adult, female adult TB patients who dropped out from TB treatment more than 2 moths in 2000-2009
Number of reported TB cases with and without HIV-co infection in 2000-2009
Percentage of TB cases with and without HIV-co infection who died during TB treatment
in 2000-2009
Percentage of TB cases with and without HIV-co infection who dropped out from TB treatment
more than 2 moths in 2000-2009
Children who died during TB treatment
in Chiang Rai
Children TB cases who died during TB treatment in 2000-2009
Children 0-4 years Children 5-14 years
Died/Total(%) Died/Total(%)
Characteristics 18/194 (9.3%) 44/377 (11.7%)
Gender
Girl 8/94 (8.5%) 22/199 (11.1%)
Boy 10/100 (10%) 22/178 (12.4%)
Race
Thai 7/98 (7.1%) 30/198 (15.2%)
Hilltribe 3/60 (5%) 10/102 (9.8%)
NonThai 8/36 (22.2%) 4/77 (5.2%)
HIV-co infection
Without HIV-co infection 6/92 (6.5%) 6/156 (3.8%)
With HIV-co infection 9/24 (37.5%) 32/98 (32.7%)
HIV unknown 3/78 (3.8%) 6/123 (4.9%)
Children TB cases who died during TB treatment in 2000-2009
Children 0-4 years Children 5-14 years
Died/Total(%) Died/Total(%)
Characteristics 18/194 (9.3%) 44/377 (11.7%)
Without HIV-co infection
Thai 0/40 (0%) 1/62 (1.6%)
Hilltribe 1/32 (3.1%) 3/48 (6.3%)
NonThai 5/20 (25%) 2/46 (4.3%)
With HIV-co infection
Thai 7/17 (41.2%) 27/80 (33.8%)
Hilltribe 1/2 (50%) 4/7 (57.1%)
NonThai 1/5 (20%) 1/11 (9.1%)
HIV unknown
Thai 0/41 (0%) 2/56 (3.6%)
Hilltribe 1/26 (3.8%) 3/47 (6.4%)
NonThai 2/11 (18.2%) 1/20 (5%)