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searo searo Home About WHO in SEAR SEAR Countries Topics List Regional Health Situation Informati on Sources Related Websites Communi cable Diseases Tubercul osis TB in SouthEast Asia Factsheets on TB WHO support in the Region Training materials Media centre Publications Related websites Contact us searo xml_no_dtd Communicable Diseases Department Tuberculosis TB in South-East Asia Epidemiology Goals and Objectives Achievements Key Milestones achieved in 2008 Country Profiles Country Profiles – Thailand With a population of approximately 64 million Thailand ranks 18th in the list of 22 high TB burden countries. The prevalence of TB was estimated at 192 per 100 000 population for all forms in 2007, with an incidence rate of 62 new smear-positive cases per 100 000 population. The country has achieved full DOTS coverage, maintaining the global target for case detection since 2003. A case detection rate of 72 % was achieved in 2007.The treatment success rate for the cases reported for 2006 was 77%. The low treatment success rate is attributed to high default and mortality rates and incomplete reporting from the city of Bangkok. Based on a national drug resistance survey in 2006, MDR-TB rates were reported to be 1.65 % among newly diagnosed cases and 34.5 % among previously treated cases. Thailand has an extensive and well developed laboratory network. However, due to the decentralized nature of laboratory services and the presence of several private sector laboratories also undertaking TB diagnosis, maintaining quality assurance is one of the major challenges faced by the NTP. Most patients with drug-resistant tuberculosis are diagnosed and managed by university, regional/provincial and some private hospitals, which procure second-line anti-TB drugs using local resources. National guidelines for MDR-TB, in line with international recommendations, have been developed and adopted by the national experts. Culture and DST is recommended for all patients who fail Category I and II regimens, contacts of MDR-TB cases, all patients commencing retreatment regimens, HIV infected TB cases, migrants and prisoners. The capacity for first-line DST is being expanded through the establishment of culture facilities at selected regional laboratories. The national reference laboratory has capacity for second-line DST, and has recently been formally designated as the second SNRL in the South-East Asia Region. Substantial progress has been made in implementing TB/HIV collaborative activities throughout the country. A national working group for TB/HIV has been established and the NTP provides guidance for collaborative TB/HIV activities. Diagnostic HIV testing of TB patients has been incorporated into national guidelines and is being increasingly implemented throughout the country. Routine HIV screening is recommended nationally for all registered TB patients. In 2007, the HIV counseling and testing rate among TB patients was 68 %, and 20 % among all those tested were found to be HIVinfected. Care and treatment for HIV-infected persons is highly subsidized and widely available. Cotrimoxazole preventive therapy and anti-retroviral treatment was provided to 67 % and 32 % respectively, of HIV-positive TB patients. Improved identification of HIV-infected TB patients, together with effective linkage to care and treatment will be required to significantly reduce TB mortality rates. An HRD plan has been developed and a focal point for HR designated at the central level. TB services are fully integrated within primary health care. Thailand has made remarkable progress in involving NGOs and the private sector. Recently a Memorandum of Understanding was signed with the National Health Security Office, Ministry of Labour and Médecins Sans Frontières (MSF) for implementation of TB in workplaces, prisons and among migrants. The programme has involved private hospital associations, NGOs (World Vision, American Refugee Committee, and Thailand Business Coalition of AIDS to control TB) to provide TB care according to ISTC. The country’s TB programme is supported by GF and other bilateral partners and additional funding has been allocated by the National Health Security Office. Major achievements The National Health Security Office has provided additional funds to support TB activities at the provincial and local levels; TB/HIV collaborative activities have been scaled up countrywide; TB services among marginalized populations such as migrants and cross-bordered population have been maintained by collaborating with NGOs through GFATM support; Establishing TB services in 138 prisons; Greater commitment from the Ministry of Public Health: designation of a “Mr/Ms TB” at all hospitals and provisional health offices; Managing Information for Action (MIFA) course introduced; and Global Fund support through Rounds 6 and 8. Major challenges and constraints Improving quality of DOTS in decentralized situation and in big cities; Further strengthening TB/HIV integrated activities; Better managing systematic and regular supervision of programme activities; Ensuring systematic MDR-TB care and recording and reporting on these cases; Involving private hospitals in TB control; Obtaining adequate commitment for implementing TB control activities in Bangkok; and Addressing Human resource constraints at the central and Regional levels. Planned Activities Capacity building of health care volunteers in decentralized settings and in big cities to ensure treatment adherence; Strengthening of regular supervision, monitoring and evaluation of the programme; Piloting MDR-TB treatment under the programme; procurement of second-line drugs through GLC; Increasing the involvement of private hospitals and ensuring practices are in line with the national guidelines; Advocating with the Bangkok Metropolitan Administration for greater commitment for TB Control; and Updating the database of health staff in place and developing a strategic plan according to the need. TB epidemiological profile, Thailand TB Unit of the WHO Regional Office for South-East Asia Last update: 12 March 2009 | WHO/SEARO Home| SEARO Search| Suggestions| SEARO Sitemap| Contact us| © WHO Regional Office for South-East Asia 2012 All rights reserved