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

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

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

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

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,
BTB-Updated : May 28, 2013

8. Treatment outcome,
BTB-Updated : May 28, 2013

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

10. Estimates of MDR-TB burden (2011),Thailand
Estimates among notified cases
% of new TB cases with MDR-TB
1.7 (1.0–2.6)
% of retreatment TB cases with MDR-TB
35 (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)

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

18. Prelim. Result: National TB Prevalence Survey, 2012 (Non-BKK)
PRELIMINARY RESULT. NOT FOR REFERENCE
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%
ข้อสังเกตจากข้อมูลในสไลด์
การสำรวจ มีลักษณะผู้ป่วยต่างจากที่พบในระบบรายงาน คือ เสมหะบวกทีเพียงร้อยละ 41 ในขณะที่ในระบบรายงาน มีเสมหะบวกประมาณร้อยละ 60
การพบผู้ป่วยโดยที่ไม่มีอาการเข้าเกณฑ์สูงถึง ร้อยละ 65% (สองในสาม)

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

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

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

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

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

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

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

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

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

28. Plan for DR-TB

29. Plan for DR-TB

30. ขอบคุณครับ