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Jintana Ngamvithayapong-Yanai, PhD. • JSPS-Fellow, Research Institute of Tuberculosis, Japan
• TB/HIV Research Foundation, Chiang Rai, Thailand
7th International Congress on AIDS in Asia and Pacific,
Kobe, Japan July 1-5, 2005
Acknowledgement• TB/HIV patients and families
• Japanese Foundation for AIDS Prevention (JFAP) and Ministry of Health, Welfare and Labor, Japan supported the TB/HIV research conducted in Chiang Rai, Thailand.
Chiang Rai, Thailand
Cambodia
Myanmar
China
Laos
Vietnam
Bangkok
Chiang Rai
0
10
20
30
40
50
60
70
80
90
100
110
120
130
140
1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
HIV negativeHIV unknown
HIV positive
New TB rate by HIV status per 100,000 persons 1987-2002
Age and sex HIV status
TB treatment outcome
44 – M Negative Cured
21-M Negative Cured
19- M Negative Cured
26-F Negative Cured
29-F Negative Cured
34-F Negative Died after 1 month
28-M Positive Died after 3 months
22-M Positive Died after 3 weeks.
33-M Positive Died after 1 month
36-M Positive Died after 7 months
35-F Positive Died after 7 months
42 –F Positive Cured
34- F Positive Cured
TB treatment outcome of some pulmonary TB patients by HIV status
Killing…despite HIV-Negative TB
“I have been coughing for a year but I just bought anti cough syrup from the drug stores. Eventually, my sisters begged to me to have a blood test. They accompanied me to a private laboratory. I dared not to listen to the test result by myself. My sisters did that for me. They were extremely delighted to tell me that my blood was” negative”. I did not believe them...I thought they were afraid that I would commit suicide...so they lied to me. Even when they went to buy 2 dozen of beers and cerebrated with my family, I still hardly believed them. Only when the second test was done in the hospital, I became convinced. Doctor said I have tuberculosis not AIDS. ”
Attitude of health staff regarding TB/HIV
Attitude of health staff regarding TB/HIV
...We have many works that we have to do in
the health center. TB/HIV patients usually died soon after a few
weeks of TB treatment. Finally,they would die
because of AIDS anyway. We can not
help them. They are less priority. (Focus Group
Discussion with health center staff.)
TB/HIV Research Project(RIT-JATA)TB/HIV Research Project(RIT-JATA)
Fatalism (accept to die) among people with HIV/AIDS before the era of ARV
“My relatives said, “Going to hospital does not help. You will not be cured. Don’t go. If you can live…you just live. If you can not live, just prepare for the next birth in the next world. Whatever will be will be… Let it be.” Many of my siblings and relatives (seven) have died of AIDS. I am the only remaining person! I accepted not to go to the hospital. Just die…just die.”
(a TB(HIV+) male patient having major TB drug reactions but nobody brought him to the hospital)
“Love”can increase adherence
I LOVE my mom and dad. Doctor said if I take medicine, I will not spread TB. Therefore, I must take the medicine. I must prevent my parents from getting TB from me.A 35 years old TB(HIV+) patient
Unfortunately, my daughter died after TB was cured because no poor patients could pay for anti-retrovirus drugs. But now several TB/HIV patients in my community can survive, they can live with their family and can feed the family. I missed my daughter….
I miss my daughter…
What will happen if there is a strong collaboration
between AIDS and TB programs?
AIDSprogram
TB program
TB/HIVpatient
TB/HIV Research Project(RIT-JATA)TB/HIV Research Project(RIT-JATA)