Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Teeraratkul A [original query] |
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National health information systems for achieving the Sustainable Development Goals
Suthar AB , Khalifa A , Joos O , Manders EJ , Abdul-Quader A , Amoyaw F , Aoua C , Aynalem G , Barradas D , Bello G , Bonilla L , Cheyip M , Dalhatu IT , De Klerk M , Dee J , Hedje J , Jahun I , Jantaramanee S , Kamocha S , Lerebours L , Lobognon LR , Lote N , Lubala L , Magazani A , Mdodo R , Mgomella GS , Monique LA , Mudenda M , Mushi J , Mutenda N , Nicoue A , Ngalamulume RG , Ndjakani Y , Nguyen TA , Nzelu CE , Ofosu AA , Pinini Z , Ramirez E , Sebastian V , Simanovong B , Son HT , Son VH , Swaminathan M , Sivile S , Teeraratkul A , Temu P , West C , Xaymounvong D , Yamba A , Yoka D , Zhu H , Ransom RL , Nichols E , Murrill CS , Rosen D , Hladik W . BMJ Open 2019 9 (5) e027689 OBJECTIVES: Achieving the Sustainable Development Goals will require data-driven public health action. There are limited publications on national health information systems that continuously generate health data. Given the need to develop these systems, we summarised their current status in low-income and middle-income countries. SETTING: The survey team jointly developed a questionnaire covering policy, planning, legislation and organisation of case reporting, patient monitoring and civil registration and vital statistics (CRVS) systems. From January until May 2017, we administered the questionnaire to key informants in 51 Centers for Disease Control country offices. Countries were aggregated for descriptive analyses in Microsoft Excel. RESULTS: Key informants in 15 countries responded to the questionnaire. Several key informants did not answer all questions, leading to different denominators across questions. The Ministry of Health coordinated case reporting, patient monitoring and CRVS systems in 93% (14/15), 93% (13/14) and 53% (8/15) of responding countries, respectively. Domestic financing supported case reporting, patient monitoring and CRVS systems in 86% (12/14), 75% (9/12) and 92% (11/12) of responding countries, respectively. The most common uses for system-generated data were to guide programme response in 100% (15/15) of countries for case reporting, to calculate service coverage in 92% (12/13) of countries for patient monitoring and to estimate the national burden of disease in 83% (10/12) of countries for CRVS. Systems with an electronic component were being used for case reporting, patient monitoring, birth registration and death registration in 87% (13/15), 92% (11/12), 77% (10/13) and 64% (7/11) of responding countries, respectively. CONCLUSIONS: Most responding countries have a solid foundation for policy, planning, legislation and organisation of health information systems. Further evaluation is needed to assess the quality of data generated from systems. Periodic evaluations may be useful in monitoring progress in strengthening and harmonising these systems over time. |
HIV Drug Resistance among Pre-treatment Cases in Thailand: Four Rounds of Surveys during 2006-2013
Thanprasertsuk S , Phokhasawad K , Teeraratkul A , Chasombat S , Pattarapayoon N , Saeng-Aroon S , Yuktanon P , Kohreanudom S , Lertpiriyasuwat C . Outbreak Surveill Investig Rep 2018 11 (1) 6-13 In Thailand, antiretroviral therapy (ART) was initiated to treat human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) cases using the empirical regimen with no prior genotypic test to determine drug resistance. In order to assess prevalence rate of HIV drug resistance (HIVDR) among pre-treatment cases, four rounds of survey were carried out in ART clinics, including six, eight, 33 and four ART clinics in each round during 2006-2013. For which, HIVDR testing results were available in 310, 350, 797, and 413 cases in four rounds. It was revealed that HIVDR rates among naive cases were 2.0%, 2.8%, 4.0% and 4.8%, while in experienced cases, the rates were 0, 3.3%, 11.4% and 13.9%. The rates among all cases were 1.9%, 2.9%, 4.4% and 5.6%. Resistant drugs with the highest rates among all cases in the survey round 4 were nevirapine (3.6%) and efavirenz (3.1%). The results indicated the need to continue surveillance for pre-treatment HIVDR, and posed challenges to implement activities for protecting efficacy and prolong the use of empirical first-line regimen. A strategy to apply genotyping test, in a cost-effective approach, should be considered to prepare for situation when HIVDR increases beyond a critical level. |
Loss to follow-up and associated factors of patients through the National AIDS Program in Thailand
Teeraananchai S , Kerr SJ , Ruxrungtham K , Avihingsanon A , Chaivooth S , Teeraratkul A , Bhakeecheep S , Ongwandee S , Thanprasertsuk S , Law MG . Antivir Ther 2018 23 (6) 529-538 BACKGROUND: Loss to follow-up is a crucial indicator to evaluate the effective of HIV care and treatment program. We assessed the LTFU rate and associated factors of Thai HIV-infected patients who enrolled in the National AIDS program (NAP) for 2 periods: prior to (pre-ART) and after starting ART (ART-patients). METHODS: Thai HIV patients aged >/= 15 years enrolled in NAP from 2008 to 2014. Vital status was ascertained by linkage with the National Death Registry. Competing risk models were used to calculate the adjusted sub-distribution hazards (aSHR) for LTFU for pre-ART and ART patients, with death considered as a competing risk. RESULTS: A total of 157,026 patients registered in care and were included in analyses. The cumulative incidence of LTFU in pre-ART patients at 1 year was 10.2%, whereas in ART-patients it was 12.8%. Among pre-ART patients, younger age (< 30 vs age >/= 45, aSHR 1.60, 95%CI 1.49-1.72), less advanced HIV stage (aSHR 1.29, 95%CI 1.21-1.37) and higher CD4 count (>/= 350 vs < 100; aSHR 6.31, 95%CI 5.74-6.95) had a higher chance of LTFU. ART-patients with high baseline CD4 count (CD4 >/= 350 vs CD4 < 50; aSHR 2.06, 95%CI 1.97-2.15) and non-advanced HIV stage had increased risk of LTFU. CONCLUSIONS: Our findings provide new evidence of the LTFU rate in Thai HIV-infected patients in NAP. Emphasis needs to be placed on improving follow up in all patients with higher CD4 counts. LTFU will be important to monitor as programs move to commence ART regardless of CD4 count. |
Monitoring HIV drug resistance: Early warning indicators to assess performance of Thailand's antiretroviral treatment program
Lertpiriyasuwat C , Teeraratkul A , Suchonwanich Y , Chatharojwong N , Phokasawad K , Yuktanon P , Pattarapayoon N , Bhakeecheep S , Bertagnolio S , Roels TH , Thanprasertsuk S . J Med Assoc Thai 2017 100 (9) 944-952 Objective: To describe trends in Thailand's antiretroviral treatment (ART) program performance assessed by HIV drug resistance early warning indicators (EWIs), as recommended by WHO, between 2009 and 2013. Material and Method: Seven EWIs were monitored, viral load (VL) testing coverage, VL suppression, retention in ART, lost to follow-up (LTFU), antiretrovirals (ARVs) dispensing practices, on-time pill pick-up, and pharmacy stock-outs. Data from ART adult patients in National Health Security Office Scheme were analyzed except for pharmacy stock-outs, which were reported from hospitals. Aggregated averages were calculated for each EWI. Chi-square for trend was applied to measure significant changes. Results: By September 2013, 174,284 adults were receiving ART at 929 hospitals. Over time, improvement in VL testing coverage (53.8% in 2009 to 79.8% in 2013) was observed. VL suppression and on-time pill pick up rates were well above 90%. Rates of retention in ART declined from 84.0 to 82.9%, whereas LTFU rates increased from 8.3 to 9.2% (p<0.001). Prescriptions with inappropriate ARVs decreased from 0.32 to 0.10% (p<0.001). Of reporting hospitals, 96.1%, 96.3%, and 96.2% observed no ARVs stock-out between 2011 and 2013. Conclusion: EWI is a useful tool to monitor ART program performance and to identify area where improvement is needed. |
Life expectancy after initiation of combination antiretroviral therapy in Thailand
Teeraananchai S , Chaivooth S , Kerr SJ , Bhakeecheep S , Avihingsanon A , Teeraratkul A , Sirinirund P , Law MG , Ruxrungtham K . Antivir Ther 2017 22 (5) 393-402 BACKGROUND: Access to combination antiretroviral therapy (cART) has decreased mortality in HIV positive people. We aimed to estimate the expected additional years of life in HIV-positive Thai people after starting cART through the National AIDS Program (NAP), administered by the Thai National Health Security Office (NHSO). METHODS: The NHSO database collects characteristics of all Thai HIV-infected patients through the National AIDS Program, including linkage with the National Death Registry for vital status. This study included patients aged ≥15 years at cART initiation between 2008 and 2014. The abridged life table method was used to construct life tables stratified by sex and baseline CD4 cell count. Life expectancy was defined as the additional years of life from age at starting cART. RESULTS: 201,688 eligible patients were included in analyses, contributing 618,837 person-years of follow-up. Median CD4 was 109 cells/mm3 and median age 37 years. The overall life expectancy after cART initiation at age 20 was 25.4 (95%CI, 25.3-25.6) years and 20.6 (95%CI, 20.5-20.7) at age 35 years. Life expectancy at baseline CD4 cell count ≥ 350 cells/mm3 was 51.9 (95% CI, 51.0-52.9) years for age 20 years, and 43.2 (95%CI, 42.4-44.1) years for age 35 years, close to life expectancy in the general Thai population. CONCLUSIONS: Increasing life expectancy with higher baseline CD4 cell counts supports the guideline recommendations to start cART irrespective of CD4 cell count. These results are beneficial to forecast the treatment cost and develop health policies for people living with HIV in Thailand and Asia. |
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