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Clin Infect Dis 1996;23:954-62HIV

Clin Infect Dis 1996;23:954-62

(Risk for TB)Diabetes mellitus ()Silicosis ()Prolonged therapy with corticosteroids ()Immunosuppressive therapy ()Leukemia, Hodgkins disease, head and neck cancers ()Severe kidney disease ()Malnutrition ()HIV infection ()Alcoholism () ()

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1.7 million people died from TB in 20099.4 million new TB cases in 2009The estimated global incidence rate : 137 cases per 100 000 population in 2009It was estimated that in 2009, 3.3% of all new TB cases had MDR-TBXDR-TB cases have been confirmed in 58 countries

* : WHO, Global TB Control -2010 report (10)57

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*2010TB : 654(1/105)29413th12thWithin 10 leading cause of death11th2.817th 101947-2010

*

*Taiwan TB treatment outcomes at 12 months 2005-2008WHO Target

*

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* Plan 1 Plan 2 Plan 3 - Plan 4 Plan 5 MDR(DOTS-Plus) Plan 6 Plan 7 Plan 8 Plan 9 Plan 10 Plan 11 Plan 12 Plan 13 Plan 14 & (PETTSDOTS ) Plan 15

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*Thanks for your attention! !!

()TB10********10% 230% ****2010WHO Global TB Control Report2009200920102009105820101057**20111210EIC201115,774 (16,570)12,600(12,605)80 %78.9% (38.9%)CDC2.92011 MDRTB272(2011155) 28 2011 5? CDC

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*200820092009DOTS-PlusMDR2010MDR2009MDR1.3%20101.2%20122MDR-TB270XDR-TB11**2006201011201536*1.Case finding campaign: (, )2.Laboratory capacity improvement : ()3.Direct Observe Treatment (DOTs) : (TB)4.Hospital Care Enhancement & infection control :5.MDR-TB project (DOTS-Plus) :MDR (MDRTB, )6.Air Travel control : 7.Surveillance and database: 8.National Health Insurance related issues :9.Local government evaluation :10. LTBI treatment pilot program: 2008/4 Program 11. Contact tracing plus pilot project12. New immigrant program: 13. BCG evaluation14. IC(International Collaboration) & R&D(research and design): PETTS, DOTS evaluation15. Mandatory isolation implementation:

*WHO900WHO100%95.6%20121793

*1.After a patient was reported by a physician, the consultation procedure was undertook. This procedure has a double check function to ensure that the diagnosis and treatment is correct, therefore the observers wont deliver medication of incorrect regimen.2.If the patient meet inclusion criteria, the nurse who is in charge of the patient from public health center would give the patient some TB education and introduction of DOT program, either at home visit or in the hospital.3.If the patient is willing to join the program, he or she should sign a informed consent, the content includes the hand in his own medication to DOT team.4.Then the DOT observer and patient negotiate dates, places and times for DOT services. The principle is patient-centered. The list is what DOT observer should do for his daily routine work.()(9:00-9:30)()DOTSDOTS3

!

* 2006/200820092()*20097201031%6%2007112008630DOT, , , WHODOTDOTDOT60%80%60%DOT98%

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* INH 19HIV

**200528.5~240.7< 12 y/o, LTBI!

1.LTBI 20084132.{DOPT (P stands for preventive)}9 Isoniazid (INH) *200841313LTBIDOPT2010LTBIDOPT(1004842)*2010 2008/4/12009/9/30 LTBITB 13 TST>=10mmX LTBILTBIDOPT 2008/4/12009/9/30 13 (TST)XLTBITST>=10mm LTBIDOPT DOPTLTBI90 % 13133LTBI TSTLTBITB812/100000 LTBI25 TSTLTBI 96% **10EIC2005-2011TB24%37%**I hope Ive given you an overall idea about the past and present of the HIV/AIDS epidemic in Taiwan. In the future, Taiwan will continue to improve its defense against AIDS and be part of the global effort to fight the disease. The CDC will maintain its active participation in international disease control activities and establish closer communication and cooperation with other countries to ensure a healthier world. Thank you for your attention!