U.S. Assistance to Combat Tuberculosis in Vietnam
March 2009
Factsheet
Despite recent progress, tuberculosis (TB) remains a major global public health problem, with nearly nine million new cases and more than 1.7 million deaths reported worldwide each year. According to the World Health Organization (WHO), every year in Vietnam 150,000 people get TB disease, including up to 5,000 people with drug-resistant TB. Vietnam is ranked 12th on the WHO list of the 22 countries with the highest TB burdens.. The spread of HIV in some provinces may account for an increase of TB cases seen in persons 15 to 34 years of age. Currently, the WHO estimates that there are 7500 new HIV/T co-infected cases per year. To combat this public health threat, the National TB Program has formed the Stop TB Partnership to better coordinate partners, donors, and technical assistance.
Since 1995, the U.S. government has provided technical assistance to Vietnam’s National Tuberculosis program with greatly expanded support since 2004 for TB/HIV activities through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). To date, the United States has contributed $10 million to help Vietnam combat TB through the U.S. Agency for International Development and the Centers for Disease Control and Prevention of the Department of Health and Human Services. Major USG activities fall into four areas.
HIV Testing and TB Screening
Currently, U.S.-funded activities focus on strategies to reduce the burden of TB among people living with HIV. These include HIV testing for TB patients and referral for treatment for those who test positive, intensified efforts to identify persons with TB, improvements in infection control, and evaluating the best ways to screen people with HIV infection for TB. Over 20,000 TB patients were tested in 2008 at more than 100 TB clinics in 19 provinces, which, with U.S. support, now provide HIV testing and counseling services. In addition, the United States supports more than 100 HIV care sites in 30 provinces of Vietnam. These provide TB disease screening referral of HIV-infected patients who are suspected of TB to TB services for evaluation and treatment, and improved coordination of TB and HIV services. In 2008, the program has screened for TB and referred more than 12,000 people living with HIV/AIDS suspected of being co-infected with TB. Treatment for TB has been provided to more than 2,500 HIV-infected TB patients. In a bid to determine the best way to screen for TB disease among people living with HIV, the U.S. government has conducted a clinical study in Cambodia, Thailand, and Vietnam; results are expected to be released in May 2009.
Infection Control
U.S. government funds assistance to Vietnam’s National TB Program to implement stronger infection control, which reduces the spread in health care settings. The foundation of this work rests on improving health education on TB transmission and the use of personal protection equipment, through training. In addition, financial support has enabled structural renovation in eight provincial hospitals and rehabilitation centers that manage patients with HIV and drug-resistant TB.
Treatment and Case Management
Several activities encourage enhanced treatment and better case management of TB patients through referral between TB and HIV care and treatment facilities. The U.S. government also has assisted the Ministry of Health in developing a collaborative national protocol between TB and HIV programs in diagnosis, treatment, and management of TB in HIV-infected persons. As apart of a pilot program to prevent the development of TB, preventive therapy with the drug isoniazid is being given to 1,000 patients infected with HIV in the An Giang and Hai Phong Provinces and Ho Chi Minh City. In cooperation with U.S. technical partners, the national TB program is developing better ways to track and monitor TB and HIV-related information in clinics using improved clinic registry forms.
Laboratory Equipment and Training
The U.S. government supports training for clinical staff and helps improve laboratory diagnosis of TB in eight provinces. At least 150 clinical personnel have been trained to provide screening and treatment of HIV-associated TB and to support coordination activities at the district level. On-site training and mentoring of staff and assistance with reporting TB indicators complements the systems improvements. Hanoi, Ho Chi Minh City, Danang and Can Tho Provinces receive specialized support to test and treat cases of multi-drug resistant TB.