Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Anuwatnonthakate A[original query] |
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Use of drug-susceptibility testing for management of drug-resistant tuberculosis, Thailand, 2004-2008
Lam E , Nateniyom S , Whitehead S , Anuwatnonthakate A , Monkongdee P , Kanphukiew A , Inyaphong J , Sitti W , Chiengsorn N , Moolphate S , Kavinum S , Suriyon N , Limsomboon P , Danyutapolchai J , Sinthuwattanawibool C , Podewils LJ . Emerg Infect Dis 2014 20 (3) 408-16 In 2004, routine use of culture and drug-susceptibility testing (DST) was implemented for persons in 5 Thailand provinces with a diagnosis of tuberculosis (TB). To determine if DST results were being used to guide treatment, we conducted a retrospective chart review for patients with rifampin-resistant or multidrug-resistant (MDR) TB during 2004-2008. A total of 208 patients were identified. Median time from clinical sample collection to physician review of DST results was 114 days. Only 5.8% of patients with MDR TB were empirically prescribed an appropriate regimen; an additional 31.3% received an appropriate regimen after DST results were reviewed. Most patients with rifampin -resistant or MDR TB had successful treatment outcomes. Patients with HIV co-infection and patients who were unmarried or had received category II treatment before DST results were reviewed had less successful outcomes. Overall, review of available DST results was delayed, and results were rarely used to improve treatment. |
Barriers to human immunodeficiency virus testing of tuberculosis patients in Thailand, 2004-2007
Anuwatnonthakate A , Jittimanee SX , Cain J , Nateniyom S , Wattanaamornkiat W , Komsakorn S , Moolphate S , Banyati P , Chiengsorn N , Limsomboon P , Kaewsa-Ard S , Varma JK . Int J Tuberc Lung Dis 2010 14 (8) 980-5 SETTING: Tuberculosis (TB) clinics in five provinces and one national referral hospital in Thailand. OBJECTIVE: To identify risk factors for TB patients not receiving human immunodeficiency virus (HIV) pre-test counseling and testing in Thailand. DESIGN: We collected data on TB patients treated at participating facilities from 2004 to 2007. Patients with known HIV status at the time of TB diagnosis were excluded from the analysis. We performed multivariate logistic regression to determine patient and facility characteristics associated with HIV counseling and testing. RESULTS: Of 15 903 TB patients, HIV pre-test counseling was provided to 13 604 (86%). HIV testing was provided to 11 702 (86%) of those counseled. Of 6141 patients with unknown HIV status, 2323 (38%) were treated in facilities that provide HIV testing in TB clinics compared with 6412 (58%) of 11 003 non-HIV-infected and 3814 (62%) of 6121 HIV-infected patients (P < 0.05). In multivariate analysis, patients treated in facilities in which HIV testing of TB patients was performed somewhere other than the TB clinic were significantly less likely to undergo HIV pre-test counseling (adjusted OR 1.55, 95%CI 1.28-1.86). CONCLUSION: In Thailand, providing HIV testing directly in TB clinics, rather than in other settings, may increase the proportion of TB patients with known HIV status. |
Multidrug-resistant TB and HIV in Thailand: overlapping, but not independently associated, risk factors
Akksilp S , Wattanaamornkiat W , Kittikraisak W , Nateniyom S , Rienthong S , Sirinak C , Ngamlert K , Mankatittham W , Sattayawuthipong W , Sumnapun S , Yamada N , Monkongdee P , Anuwatnonthakate A , Burapat C , Wells CD , Tappero JW , Varma JK . Southeast Asian J Trop Med Public Health 2009 40 (5) 1000-14 The HIV and multi-drug resistant tuberculosis (MDR-TB) epidemics are closely linked. In Thailand as part of a sentinel surveillance system, we collected data prospectively about pulmonary TB cases treated in public clinics. A subset of HIV-infected TB patients identified through this system had additional data collected for a research study. We conducted multivariate analysis to identify factors associated with MDR-TB. Of 10,428 TB patients, 2,376 (23%) were HIV-infected; 145 (1%) had MDR-TB. Of the MDR-TB cases, 52 (37%) were HIV-infected. Independent risk factors for MDR-TB included age 18-29 years old, male sex, and previous TB treatment, but not HIV infection. Among new patients, having an injection drug use history was a risk factor for MDR-TB. Of 539 HIV-infected TB patients in the research study, MDR-TB was diagnosed in 19 (4%); the only significant risk factors were previous TB treatment and previous hepatitis. In Thailand, HIV is common among MDR-TB patients, but is not an independent risk factor for MDR-TB. Populations at high risk for HIV-young adults, men, injection drug users - should be prioritized for drug susceptibility testing. |
Factors associated with death among HIV-uninfected TB patients in Thailand, 2004-2006
Amnuaiphon W , Anuwatnonthakate A , Nuyongphak P , Sinthuwatanawibool C , Rujiwongsakorn S , Nakara P , Komsakorn S , Wattanaamornkiet W , Moolphate S , Chiengsorn N , Kaewsaard S , Nateniyom S , Varma JK . Trop Med Int Health 2009 14 (11) 1338-46 OBJECTIVES: In countries with both TB and human immunodeficiency virus (HIV) epidemics, HIV is known to be the most powerful risk factor for death during tuberculosis (TB) treatment. Few recent studies have evaluated risk factors for death among HIV-uninfected TB patients in these countries. We analysed data from a multi-province demonstration project in Thailand to answer this question. METHOD: We prospectively collected data from HIV-uninfected TB patients treated for TB in four provinces and the national infectious diseases hospital in Thailand from 2004-2006. Standard WHO definitions were used to classify treatment outcomes. We used log-binomial multivariate regression to calculate adjusted relative risk (aRR) and 95% confidence intervals (CI) for factors associated with death. RESULTS: Of 5318 cases, 441 (8%) died during TB treatment. The mean age was 47 years (range 8 months-97 years). Multidrug-resistant (MDR)-TB was diagnosed in 62 (1%). In multivariate analysis, patients older than 44 years were significantly more likely to die than patients aged 15-44 years [age 45-64, aRR 2.9 (CI 2.2-3.8)] [age > 64 years, aRR 5.0 (CI 3.9-6.6)]. Other independent risk factors for death included Thai nationality [aRR 3.9 (CI 1.6-9.5)], MDR-TB [aRR 2.8 (CI 1.7-4.8)], not being married [aRR 1.4 (CI 1.2-1.7)], and living in Chiang Rai province [aRR 2.7 (CI 1.7-4.4)]. CONCLUSIONS: The death rate was high among HIV-uninfected TB patients in Thailand. Efforts to improve TB diagnosis and treatment in the elderly and to improve MDR-TB treatment may help reduce mortality. |
Tuberculosis services and treatment outcomes in private and public health care facilities in Thailand, 2004-2006
Chengsorn N , Bloss E , Anekvorapong R , Anuwatnonthakate A , Wattanaamornkiat W , Komsakorn S , Moolphate S , Limsomboon P , Kaewsa-ard S , Nateniyom S , Kanphukiew A , Varma JK . Int J Tuberc Lung Dis 2009 13 (7) 888-94 BACKGROUND: The World Health Organization recommends that national tuberculosis (TB) programs encourage public and private providers to follow the 'International standards for tuberculosis care'. We assessed services and treatment outcomes in TB patients in public and private facilities to inform public-private mix scale-up in Thailand. METHODS: We prospectively collected data on TB patients in four provinces and the national infectious diseases hospital during 2004-2006. We analyzed services and outcomes among new pulmonary TB patients according to facility type. RESULTS: Of 7526 patients, 4539 (60%) were treated in small public facilities, 2275 (30%) in large public facilities and 712 (10%) in private facilities. Compared with the private sector, more public sector patients had at least two sputum smears examined, were prescribed a standard anti-tuberculosis regimen and received directly observed therapy; however, public sector facilities also performed suboptimally. Treatment outcomes were unsuccessful for 237 (33%) patients in private facilities, and for respectively 1018 (23%) and 655 (29%) patients in small and large public facilities. CONCLUSIONS: TB diagnostic and treatment services and outcomes should be enhanced in both public and private facilities in Thailand. Initiatives are needed to improve treatment outcomes and increase the use of microscopy, standardized TB regimens, and directly observed therapy in the public and private sectors. |
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