Journal Article > ResearchFull Text
Infect Dis Poverty. 24 March 2017 (Issue 1)
Han WW, Saw S, Isaakidis P, Khogali MA, Reid A, et al.
Infect Dis Poverty. 24 March 2017 (Issue 1)
International non-governmental organizations (INGOs) have been implementing community-based tuberculosis (TB) care (CBTBC) in Myanmar since 2011. Although the National TB Programme (NTP) ultimately plans to take over CBTBC, there have been no evaluations of the models of care or of the costs of providing CBTBC in Myanmar by INGOs.
Journal Article > ResearchFull Text
Infect Dis Poverty. 2 June 2017; Volume 6 (Issue 1); DOI:10.1186/s40249-017-0291-5
Myint O, Saw S, Isaakidis P, Khogali MA, Reid A, et al.
Infect Dis Poverty. 2 June 2017; Volume 6 (Issue 1); DOI:10.1186/s40249-017-0291-5
Since 2005, the Myanmar National Tuberculosis Programme (NTP) has been implementing active case finding (ACF) activities involving mobile teams in hard-to-reach areas. This study revealed the contribution of mobile team activities to total tuberculosis (TB) case detection, characteristics of TB patients detected by mobile teams and their treatment outcomes.
Journal Article > ResearchFull Text
Public Health Action. 21 March 2016; Volume 6 (Issue 1); 25-31.; DOI:10.5588/pha.15.0068
Phuong NT, Nhung NV, Hoa NB, Thuy HT, Takarinda KC, et al.
Public Health Action. 21 March 2016; Volume 6 (Issue 1); 25-31.; DOI:10.5588/pha.15.0068
SETTING
The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009.
OBJECTIVES
To document the annual numbers of patients enrolled for multidrug-resistant tuberculosis (MDR-TB) treatment during 2010-2014 and to determine characteristics and treatment outcomes of patients initiating treatment during 2010-2012.
DESIGN
A retrospective cohort study using national reports and data from the national electronic data system for drug-resistant TB.
RESULTS
The number of patients enrolled annually for MDR-TB treatment increased from 97 in 2010 to 1522 in 2014. The majority of patients were middle-aged men who had pulmonary disease and had failed a retreatment regimen; 77% had received ⩾2 courses of TB treatment. Favourable outcomes (cured and treatment completed) were attained in 73% of patients. Unfavourable outcomes included loss to follow-up (12.5%), death (8%) and failure (6.3%). Having had ⩾2 previous treatment courses and being human immunodeficiency virus-positive were associated with unfavourable outcomes.
CONCLUSION
Increasing numbers of patients are being treated for MDR-TB each year with good treatment outcomes under national programme management in Viet Nam. However, there is a need to increase case detection-currently at 30% of the estimated 5100 MDR-TB cases per year, reduce adverse outcomes and improve monitoring and evaluation.
The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009.
OBJECTIVES
To document the annual numbers of patients enrolled for multidrug-resistant tuberculosis (MDR-TB) treatment during 2010-2014 and to determine characteristics and treatment outcomes of patients initiating treatment during 2010-2012.
DESIGN
A retrospective cohort study using national reports and data from the national electronic data system for drug-resistant TB.
RESULTS
The number of patients enrolled annually for MDR-TB treatment increased from 97 in 2010 to 1522 in 2014. The majority of patients were middle-aged men who had pulmonary disease and had failed a retreatment regimen; 77% had received ⩾2 courses of TB treatment. Favourable outcomes (cured and treatment completed) were attained in 73% of patients. Unfavourable outcomes included loss to follow-up (12.5%), death (8%) and failure (6.3%). Having had ⩾2 previous treatment courses and being human immunodeficiency virus-positive were associated with unfavourable outcomes.
CONCLUSION
Increasing numbers of patients are being treated for MDR-TB each year with good treatment outcomes under national programme management in Viet Nam. However, there is a need to increase case detection-currently at 30% of the estimated 5100 MDR-TB cases per year, reduce adverse outcomes and improve monitoring and evaluation.
Journal Article > ReviewAbstract
Asian Pac J Trop Dis. 14 March 2016; Volume 6 (Issue 3); DOI:10.1016/S2222-1808(15)61023-4
Harries AD, Kumar AMV, Kyaw NTT, Hoa NB, Takarinda KC, et al.
Asian Pac J Trop Dis. 14 March 2016; Volume 6 (Issue 3); DOI:10.1016/S2222-1808(15)61023-4
With the adoption of the new Sustainable Development Goals in 2016, all countries have committed to end the tuberculosis (TB) epidemic by 2030, defined as dramatic reductions in TB incidence and mortality combined with zero TB-induced catastrophic costs for families. This paper explores how antiretroviral therapy (ART) in high HIV-TB burden countries may help in reducing TB incidence and mortality and thus contribute to the ambitious goal of ending TB. ART in people living with HIV has a potent TB preventive effect, with this being most apparent in those with the most advanced immunodeficiency. Early ART also significantly reduces the risk of TB, and with new World Health Organization guidance released in 2015 about initiating ART in all persons living with HIV irrespective of CD4 count, there is the potential for enormous benefit at the population level. Already, several countries with high HIV-TB burdens have seen dramatic declines in TB case notification rates since ART scale up started in 2004. In patients already diagnosed with HIV-associated TB, mortality can be significantly decreased by ART, especially if started within 2–8 weeks of anti-TB treatment. The benefits of ART on TB incidence and TB mortality can be further augmented respectively by the addition of isoniazid preventive therapy and cotrimoxazole preventive therapy. These interventions must be effectively implemented and scaled up in order to end the TB epidemic by 2030.
Journal Article > CommentaryFull Text
Public Health Action. 21 June 2014; Volume 4; DOI:10.5588/pha.14.0011
Ramsay AR, Harries AD, Zachariah R, Bissel K, Hinderaker SG, et al.
Public Health Action. 21 June 2014; Volume 4; DOI:10.5588/pha.14.0011
Journal Article > ResearchFull Text
Infect Dis Poverty. 3 April 2017; Volume 6 (Issue 1); 51.; DOI:10.1186/s40249-017-0253-y
Maung YNM, Saw S, Isaakidis P, Khogali MA, Reid AJ, et al.
Infect Dis Poverty. 3 April 2017; Volume 6 (Issue 1); 51.; DOI:10.1186/s40249-017-0253-y
BACKGROUND
It is estimated that the standard, passive case finding (PCF) strategy for detecting cases of tuberculosis (TB) in Myanmar has not been successful: 26% of cases are missing. Therefore, alternative strategies, such as active case finding (ACF) by community volunteers, have been initiated since 2011. This study aimed to assess the contribution of a Community Based TB Care Programme (CBTC) by local non-government organizations (NGOs) to TB case finding in Myanmar over 4 years.
METHODS
This was a descriptive study using routine, monitoring data. Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database. Data from all 84 project townships in five regions and three states in Myanmar were used. The project was launched in 2011.
RESULTS
Over time, the number of presumptive TB cases that were referred decreased, except in the Yangon Region, although in some areas, the numbers fluctuated. At the same time, there was a trend for the proportion of cases treated, compared to those referred, that decreased over time (P = 0.051). Overall, among 84 townships, the contribution of CBTC to total case detection deceased from 6% to 4% over time (P < 0.001).
CONCLUSIONS
Contrary to expectations and evidence from previous studies in other countries, a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years. This suggests that measures to support the volunteer network and improve its performance are needed. They may include discussion with local NGOs human resources personnel, incentives for the volunteers, closer supervision of volunteers and improved monitoring and evaluation tools.
It is estimated that the standard, passive case finding (PCF) strategy for detecting cases of tuberculosis (TB) in Myanmar has not been successful: 26% of cases are missing. Therefore, alternative strategies, such as active case finding (ACF) by community volunteers, have been initiated since 2011. This study aimed to assess the contribution of a Community Based TB Care Programme (CBTC) by local non-government organizations (NGOs) to TB case finding in Myanmar over 4 years.
METHODS
This was a descriptive study using routine, monitoring data. Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database. Data from all 84 project townships in five regions and three states in Myanmar were used. The project was launched in 2011.
RESULTS
Over time, the number of presumptive TB cases that were referred decreased, except in the Yangon Region, although in some areas, the numbers fluctuated. At the same time, there was a trend for the proportion of cases treated, compared to those referred, that decreased over time (P = 0.051). Overall, among 84 townships, the contribution of CBTC to total case detection deceased from 6% to 4% over time (P < 0.001).
CONCLUSIONS
Contrary to expectations and evidence from previous studies in other countries, a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years. This suggests that measures to support the volunteer network and improve its performance are needed. They may include discussion with local NGOs human resources personnel, incentives for the volunteers, closer supervision of volunteers and improved monitoring and evaluation tools.