PTC : 57 2551

1
??????????????????????????????
??????? PTC 5-7 ??????? 2551

• ??. ???????? ????????
• ??????????? ????????????

2
outlines

• ?????????????????????????????????
• ???????????????????????
• ?????????????????????????
• ?????????????????????????????????????
• ????????????????????????????????????

3
?????????????????????????????????
????????????????
???????? ??.
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???????????
???.
???????????????????
???????????????????????????
????????
????????????????????????
?????????
????.
?????????????????????
PCU
Line of Command
Line of Collaboration
???????????
4
?????????????????????????????.
???.
???????????
?????????????
??????????????????.
????????????
???????????????????????????
????????????????????
??????????
??????????????? ??. ???????????????????? ????????
????????? ??????????????
???????????????????? (???????)
Sub health centers
5
???????????????????????????????????????????????
1. ??????????? (central level) ???????????
???????????? 2. ???????? (Regional Level)
???????????????????????? 3. ????????????
(Provincial Level) ???????????????????????? 4.
???????????????????????? ( Health facility
level) - ???. ???. ???. ??.
6
???????????????????????????????????
???????????????????????
???????????
???????????
?????????????
???.
12 ?????????????????????
???????
???????????
75 ????????????????????????
????????????????????
??????????????????????
??????????????/??????
?????????????? ?????????
??????????????
7
???????? ????? ?????? ??????????????????
???????????
????????????????????????
????????????????????????
??????????????????????
??????????????/??????
??????????????
???????????
8
????????????????????????????????? Millennium
Development Goals ( MDGs)

• ??????? ?.?. 2005
• ???????????????? ( cure rate ) ?????????????
  ??????????????????? 85
• ???????????????????? ( case detection rate )
  ??????????????????? ??????????? 70
  ?????????????????????
• ??????? ??. 2015 ????????? ???????????
  ??????????? ?????? 50 ( ???????????????? ?.?.
  1990 )

9
?????????????????????????????? ( Strategies for
TB control )

• DOTS Strategy ( since 1996)
• The Stop TB Strategy (since 2006)

10
The Stop TB Strategy

• 6 principles
• Pursue high-quality DOTS expansion and
  enhancement
• Address TB/HIV, MDR-TB and other challenges
• Contribute to health system strengthening
• Engage all care providers
• Empower people with TB and communities
• Enable and promote research

11
1.High-quality DOTS

• ???????????? ?????????????????????????????????????
  ???????????????????????????????????????????
• ??????????????????????????????????????????????????
  ?????????????
• ???????????????????????? ????????????????????????
  ????????? ?????????????????????????????? ( DOT)
• ?????????????????????????????????????????????????
  
• ???????? ??????????????? ?????????????????????

12
Address TB/HIV, MDR-TB and other challenges

• ???????????????????????????
• ????????????????????????????????????
• ??????????????????????????? ???????
  ??????????????????? ???? ??????????????
  ??????????? ???????????????????

13
3.Contribute to health system strengthening(
??????????????????????????????????? )

• ???????????????????????????????????????
  ????????????????????? ????????
  ??????????????????? ??? ?????????????????????????
  
• ?????????????????????????????????????????????
• ??????????????????????????????????????????????????
  ???? ???? ??????????????????? ???????

14
4. Engage all care providers

• ??????????????????????????????????????????????????
  ?????????????? ???????????????????????? (
  Public-public and Public-Private Mix PPM )
• ??????????????????????????????? (International
  Standards for TB Care ISTC)

15
5. Empower people with TB and communities

• ????????????????????????????????
  ??????????????????????????????????????????????????
  ????????? (Advocacy, communication and social
  mobilization ACSM )
• ???????????????????????????????????????
  (Community participation in TB care )
• ??????????????? (Patients Charter for
  Tuberculosis Care)

16
6. Enable and promote research

• ?????????????????????? (Programmatic-based
  operational research )
• ?????????????????????????????????????? ?? ???
  ?????? ????? (Research to develop new diagnosis
  , drugs and vaccines)

17
?????????????????????????????????????(Integrated
TB/HIV Strategy)

• ?????????????? 3 ?????????
• ??????????????????????????????????????????????????
  ???
• ?????????????????????????????????????????
• ?????????????????????????????

18
1. ??????????????????????????????????????????????
???????

• 1.1 ??????????????????????????????????????????????
  ????????????????????
• 1.2 ??????????????????????????????????????????????
  ?????????
• 1.3 ??????????????????????????????????????????????
  
• 1.4 ?????????????? ?????? ?????????
  ???????????????????

19
2. ?????????????????????????????????

• The Three Is
• 2.1 ?????????????????????????????????? (
  intensify case finding ICF )
• 2.2 ???????? isoniazid ??????????????????????????
  ??? ( Isoniazid Preventive Therapy IPT )
• 2.3 ??????????????????????????????????????????????
  ????????? ( Infection Control )

20
3. ?????????????????????????????

• 3.1 ??????????????????????????????????????????????
  ? ( Counseling and HIV testing )
• 3.2 ??????????????????????????????????????????????
  ??????????????
• 3.3 ????? co-trimoxazole ???????????????????????
  ???????????????? ( Cotrimoxazole Preventive
  Therapy CPT )
• 3.4 ?????????????? ???????????????????????????????
  ??? ( Anti-retroviral Therapy ART )
• 3.5 ????????????????????????????????????

21
???????????????????????????????? TB/HIV
22
?????????????????????????????????????????????????

• ???????????
• ???. ??? ?????????????????????????? (RTC????
  Ms./Mr.TB )
• ???. ?????????????????????????????? (PTC
  ???? Ms./Mr.TB )
• ?????????
• ???. ???. ???????????????????????
  ?????????????????????????????? (HTC) ???/????
  Ms./Mr.TB
• ???. ??????????????????????? ?????????????
  Ms./Mr. TB
• ???????? ?????????????????????????? ( Full
  time TB personnel )

23
??????????????????????????????????????

• ??????????????????????????????????????????????????
  ??
• ????? ???. ???. ???. CUP ???. ???? 4 ?????
• ???????????????????????????????????? ( on the
  lob training )
• ????????? ?????????
• ??????????????????????????????
• ??????????? cohort ???? 4 ?????? ??????
  ????????????????????? (TB07) ???????????????????
  ????????? (TB07/1) ???????????????? TB08)
  ???????????????????????????????????????????
  (TB/HIV01)

24
????????????????? ??????????????????

• ??????