title: Evaluating the potential impact of the new Global Plan to Stop TB: Thailand, 2004-2005.
abstract: OBJECTIVE
  WHO's new Global Plan to Stop TB 2006-2015 advises countries with a high burden of tuberculosis (TB) to expand case-finding in the private sector as well as services for patients with HIV and multidrug-resistant TB (MDR-TB). The objective of this study was to evaluate these strategies in Thailand using data from the Thailand TB Active Surveillance Network, a demonstration project begun in 2004.
  
  
  METHODS
  In October 2004, we began contacting public and private health-care facilities monthly to record data about people diagnosed with TB, assist with patient care, provide HIV counselling and testing, and obtain sputum samples for culture and susceptibility testing. The catchment area included 3.6 million people in four provinces. We compared results from October 2004-September 2005 (referred to as 2005) to baseline data from October 2002-September 2003 (referred to as 2003).
  
  
  RESULTS
  In 2005, we ascertained 5841 TB cases (164/100 000), including 2320 new smear-positive cases (65/100 000). Compared with routine passive surveillance in 2003, active surveillance increased reporting of all TB cases by 19% and of new smear-positive cases by 13%. Private facilities diagnosed 634 (11%) of all TB cases. In 2005, 1392 (24%) cases were known to be HIV positive. The proportion of cases with an unknown HIV status decreased from 66% (3226/4904) in 2003 to 23% (1329/5841) in 2005 (P< 0.01). Of 4656 pulmonary cases, mycobacterial culture was performed in 3024 (65%) and MDR-TB diagnosed in 60 (1%).
  
  
  CONCLUSIONS
  In Thailand, piloting the new WHO strategy increased case-finding and collaboration with the private sector, and improved HIV services for TB patients and the diagnosis of MDR-TB. Further analysis of treatment outcomes and costs is needed to assess this programme's impact and cost effectiveness.
authors.affiliation: US Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. jvarma@cdc.gov
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
authors.forename: Daranee
authors.initials: D
authors.lastname: Wiriyakitjar
authors.forename: Sriprapa
authors.initials: S
authors.lastname: Nateniyom
authors.forename: Amornrat
authors.initials: A
authors.lastname: Anuwatnonthakate
authors.forename: Patama
authors.initials: P
authors.lastname: Monkongdee
authors.forename: Surin
authors.initials: S
authors.lastname: Sumnapan
authors.forename: Somsak
authors.initials: S
authors.lastname: Akksilp
authors.forename: Wanchai
authors.initials: W
authors.lastname: Sattayawuthipong
authors.forename: Pricha
authors.initials: P
authors.lastname: Charunsuntonsri
authors.forename: Somsak
authors.initials: S
authors.lastname: Rienthong
authors.forename: Norio
authors.initials: N
authors.lastname: Yamada
authors.forename: Pasakorn
authors.initials: P
authors.lastname: Akarasewi
authors.forename: Charles D
authors.initials: CD
authors.lastname: Wells
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications; D006292:Health Priorities / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007373:Interinstitutional Relations; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D017149:Private Sector / Q000458:organization & administration; D015397:Program Evaluation; D017150:Public Sector / Q000458:organization & administration; D012307:Risk Factors; D018571:Sentinel Surveillance; D013785:Thailand / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D014944:World Health Organization / Q000458:organization & administration