the 5 th joint international monitoring mission to review ntp thailand, 2013
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The 5 th Joint International Monitoring Mission to review NTP Thailand, 2013. 14-19 August 2013 ODPC7 and Srisaket Province. Outline. Objectives Sites visited Overall impressions Key findings, recommendations by topic. OBjectives. Objectives of 5 th Joint Monitoring Mission of NTP. - PowerPoint PPT PresentationTRANSCRIPT
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The 5th Joint International Monitoring Mission to
review NTP Thailand, 2013
14-19 August 2013
ODPC7 and Srisaket Province
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Outline
• Objectives
• Sites visited
• Overall impressions
• Key findings, recommendations by topic
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OBJECTIVES
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Objectives of 5th Joint Monitoring Mission of NTP
• Track progress of recommendations from 2007 and 2009 reviews
• Review implementation within National TB Strategic Plan 2011-2016
• Analyse achievements and challenges
• Identify actions and areas for improvements
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Approach• 5 field teams: ODPC 9, 11, 3, 7, 1, plus
epidemiology review team
• Site criteria – Not included in previous JMM’s
And one or more of the following:– Examples of good practice
– High TB burden
– Requiring additional support
– Opportunity to assess a specific technical issue
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SITE VISITS
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ODPC 7
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Sisaket Provincial Hospital
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Sisaket Provincial Health Office
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Khuk Khan District Hospital
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Huay Nuea Primary Care Unit
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Sriritana District Hospital
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Pingpuay Primary Care Unit
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Sisaket Prison
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Samrongtagen Primary Care Unit
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Overall Impressions• Extraordinarily warm welcome; open
sharing of information
• Impressively dedicated staff at all levels, including volunteers
• Strong technical teams
• Monitoring and accountability are strong and effective
• Innovation is encouraged
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Overall Impressions (II)
• Collaboration between institutions and at different levels is excellent
• Multiple examples of best practice, opportunities for others to learn from staff teams here
• Most key TB indicators better than national average; continuing high prevalence
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Overall Impressions (III)
• Systemic challenges to efficient program implementation
• A few specific technical recommendations
• Key issue: how to translate local excellence to other areas?
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TECHNICAL AREAS
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1. Case Finding
• At every level, both testing (AFB) and SS+ case finding was high 2008-10 then decreased
• Active case finding efforts: case contacts, elderly, DM, TB/HIV, migrants, prisoners
• Symptom screening, AFB/CXR
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Case Finding• Algorithms not always clear
– Symptom questions, criteria for diagnostic assessment and which tests
• Monitoring information often not enough to evaluate yield, effectiveness of screening
• Yield appears low in most groups other than TB/HIV and DM
– Sensitivity of algorithm?
– Juice worth the squeeze?
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Case Finding: Recommendations
• Define approach clearly and track data to evaluate yield
– Asymptomatic primary screening vs. symptomatic care seekers; community vs. facility
– Target population number, number symptom screened, number with diagnostics, SS+/SS-/EP cases
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TB screening in DM patients
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ODPC7 Case Finding