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%)