Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Danyuttapolchai J[original query] |
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Programmatic evaluation of an algorithm for intensified TB case finding and isoniazid preventive therapy for people living with HIV in Thailand and Vietnam
Cowger T , Thai LH , Duong BD , Danyuttapolchai J , Kittimunkong S , Nhung NV , Nhan DT , Monkongdee P , Thoa CK , Khanh VT , Nateniyom S , Ntb Y , Ngoc DV , Thinh T , Whitehead S , Pevzner ES . J Acquir Immune Defic Syndr 2017 76 (5) 512-521 BACKGROUND: Tuberculosis (TB) screening affords clinicians opportunities to diagnose or exclude TB disease and initiate Isoniazid Preventive Therapy (IPT) for people living with HIV (PLHIV). METHODS: We implemented an algorithm to diagnose or rule out TB among PLHIV in eleven HIV clinics in Thailand and Vietnam. We assessed algorithm yield and uptake of IPT and factors associated with TB disease among PLHIV. RESULTS: A total of 1,448 PLHIV not yet on antiretroviral therapy (ART) were enrolled and screened for TB. Overall, 634 (44%) screened positive and 119 (8%) were diagnosed with TB; of these, 40% (48/119) were diagnosed by a positive culture following a negative sputum smear microscopy. In total, 55% of those eligible (263/477) started on IPT and of those, 75% (196/263) completed therapy. The prevalence of TB disease we observed in this study was 8.2% (8,218 per 100,000 persons): 46 and 25 times the prevalence of TB in the general population in Thailand and Vietnam, respectively. Several factors were independently associated with TB disease including being underweight (aOR [95% CI]: 2.3 [1.2, 2.6]) and using injection drugs (aOR [95% CI]: 2.9 [1.3, 6.3]). CONCLUSIONS: The high yield of TB disease diagnosed among PLHIV screened with the algorithm, and higher burden among PLHIV who inject drugs, underscores the need for innovative, tailored approaches to TB screening and prevention. As countries adopt Test-and-Start for ART, TB screening, sensitive TB diagnostics, and IPT should be included in differentiated-care models for HIV to improve diagnosis and prevention of TB among PLHIV. |
Implementing an isoniazid preventive therapy program for people living with HIV in Thailand
Danyuttapolchai J , Kittimunkong S , Nateniyom S , Painujit S , Klinbuayaem V , Maipanich N , Maokamnerd Y , Pevzner E , Whitehead S , Kanphukiew A , Monkongdee P , Martin M . PLoS One 2017 12 (9) e0184986 Treatment of people living with HIV (PLHIV) with latent tuberculosis (TB) infection using isoniazid preventive therapy (IPT) can reduce the risk of TB disease, however, the scale-up of IPT among PLHIV in Thailand and worldwide has been slow. To hasten the implementation of IPT in Thailand, we developed IPT implementation training curricula and tools for health care providers and implemented IPT services in seven large government hospitals. Of the 659 PLHIV enrolled, 272 (41.3%) reported symptoms of TB and 39 (14.3% of those with TB symptoms) were diagnosed with TB. A total of 346 (52.4%) participants were eligible for IPT; 318 (91.9%) of these participants opted to have a tuberculin skin test (TST) and 52 (16.3% of those who had a TST) had a positive TST result. Among the 52 participants with a positive TST, 46 (88.5%) initiated and 39 (75.0%) completed 9 months of IPT: physicians instructed three participants to stop IPT, two participants were lost to follow-up, one chose to stop therapy, and one developed TB. IPT can be implemented among PLHIV in Thailand and could reduce the burden of TB in the country. |
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