Fully vs. partially integrated services for TB-HIV in Myanmar: a health services review and a cohort study

Kyi, Myo Su; Aung, S T; Oo, Htun Nyunt; Chongsuvivatwong, Virasakdi

doi:10.5588/ijtld.18.0397

Cited by 3 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, the establishment of an effective referral system between the NTP and the National AIDS Programme (NAP) is crucial to integrate diagnostic and treatment services for both diseases, ensuring early and comprehensive care for affected individuals. 5 The study recognizes several limitations to consider. First, the data used in the study are from the MDHS 2015-16 survey, which includes individuals regardless of their TB or disease status, limiting its representativeness for all patients with TB in Myanmar.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…4 HIV-positive patients are referred to the nearest HIV centers for further case management without any charge. 5 This approach has resulted in an increase in the proportion of patients with TB with known HIV status, from 60% in 2014 to 74% in 2015. 6 However, various factors hinder HIV testing among some patients with TB, including geographical remoteness from health services, limited awareness about HIV testing, social stigma associated with HIV infection, and inadequate information about the HIV diagnostic process and results.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

HIV Testing Among Individuals With Self-reported Tuberculosis in Myanmar: A Secondary Data Analysis of the Demographic Health Survey 2015-16

Win,

Win Maung,

Show

et al. 2024

Asia Pac J Public Health

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

HIV Testing Among Individuals With Self-reported Tuberculosis in Myanmar: A Secondary Data Analysis of the Demographic Health Survey 2015-16

Win,

Win Maung,

Show

et al. 2024

Asia Pac J Public Health

View full text Add to dashboard Cite

“…All these challenges might have facilitated LFU and delays in ART initiation. These findings call for the full integration of TB and HIV services at all the health facilities, which has been shown to be effective in improving ART uptake [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

What Are the Barriers for Uptake of Antiretroviral Therapy in HIV-Infected Tuberculosis Patients? A Mixed-Methods Study from Ayeyawady Region, Myanmar

Aung¹,

Soe

Kumar

et al. 2020

TropicalMed

View full text Add to dashboard Cite

Antiretroviral therapy (ART) coverage among HIV-infected tuberculosis (HIV-TB) patients has been suboptimal in Myanmar and the reasons are unknown. We aimed to assess the ART uptake among HIV-TB patients in public health facilities of Ayeyawady Region from July 2017–June 2018 and explore the barriers for non-initiation of ART. We conducted an explanatory mixed-methods study with a quantitative component (cohort analysis of secondary programme data) followed by a descriptive qualitative component (thematic analysis of in-depth interviews of 22 providers and five patients). Among 12,447 TB patients, 11,057 (89%) were HIV-tested and 627 (5.7%) were HIV-positive. Of 627 HIV-TB patients, 446 (71%) received ART during TB treatment (86 started on ART prior to TB treatment and rest started after TB treatment). Among the 181 patients not started on ART, 60 (33%) died and 41 (23%) were lost-to-follow-up. Patient-related barriers included geographic and economic constraints, poor awareness, denial of HIV status, and fear of adverse drug effects. The health system barriers included limited human resource, provision of ART on ‘fixed’ days only, weaknesses in counselling, referral and feedback mechanism, and clinicians’ reluctance to start ART early due to concerns about immune reconstitution inflammatory syndrome. We urge the national TB and HIV programs to take immediate actions to improve the ART uptake.

show abstract

“…For patients with drug-sensitive (DS)-TB [9], multidrug-resistant (MDR)-TB [10][11][12][13], extensively drug-resistant (XDR)-TB [14], and latent TB, ongoing clinical trials will hopefully transform the landscape for treatment, which are evaluating novel agents, repurposed agents, adjunctive host-directed therapies, and novel treatment strategies [15]. There needs to be more than real-world evidence (RWE) on evaluating TB treatment effects and exploring therapeutic influencing factors in co-infected patients [16]. A small amount of real-world research suggests that TB treatment regimens' effectiveness is affected by the level of the immune system, based on which more precise TB medical strategies can be provided for co-infected patients with specific immune levels [17,18].…”

Section: Introductionmentioning

confidence: 99%

A Retroactive Study on Factors Influencing the Efficacy of Treatment for Tuberculosis Patients with HIV: based on the data from 2010 to 2020 in Shanghai, China

Dong,

Zhang,

et al. 2023

Preprint

View full text Add to dashboard Cite

At present, the factors influencing Tuberculosis (TB) treatment effectiveness in HIV/TB co-infected patients need to be supported by more substantial real-world evidence. A retrospective study is conducted to fill the vacancy. 461 TB patients with HIV are defined as 742 samples according to each TB detection period. 7788 valid treatment records corresponding to 17 drug compositions for TB and 150 clinical indicators with more than 100 records are used to conduct data mining with consensus clustering, Fisher’s exact test, stratified analysis, and three modeling approaches, including logistic regression, support vector machine, and random forest. We find that A CD4+T cell count of 42 cells per μL may serve as a sensitive classification standard for the immune level to assist in evaluating or predicting the efficacy of TB (P=0.007); Rifabutin and levofloxacin alone or in combination may be more effective than other first- and second-line anti-TB agents in combination (P=0.037); Samples with low immune levels (CD4≦42) may be more resistant to first-line TB drugs (P=0.049); Age (P=0.015), bicarbonate radical (P=0.007), high-density lipoprotein cholesterol (P=0.026), pre-treatment CD8+T cell count (P=0.015, age<60, male), neutrophil percentage (P=0.033, age<60), rifabutin (P=0.010, age<60), and cycloserine (P=0.027, age<60) may influence the TB treatment effectiveness; More evidence is needed to support the relationship between pre-treatment clinical indicators or drug regimens and TB treatment effectiveness (The best AUC is 0.560∼0.763); The percentage of lymphocytes (P=0.028) can be used as an effective TB therapeutic target. These perspectives supplement knowledge in relevant clinical aspects.

show abstract

Fully vs. partially integrated services for TB-HIV in Myanmar: a health services review and a cohort study

Cited by 3 publications

References 1 publication

HIV Testing Among Individuals With Self-reported Tuberculosis in Myanmar: A Secondary Data Analysis of the Demographic Health Survey 2015-16

HIV Testing Among Individuals With Self-reported Tuberculosis in Myanmar: A Secondary Data Analysis of the Demographic Health Survey 2015-16

What Are the Barriers for Uptake of Antiretroviral Therapy in HIV-Infected Tuberculosis Patients? A Mixed-Methods Study from Ayeyawady Region, Myanmar

A Retroactive Study on Factors Influencing the Efficacy of Treatment for Tuberculosis Patients with HIV: based on the data from 2010 to 2020 in Shanghai, China

Contact Info

Product

Resources

About