Investigation on New XDR-TB Patients by Using Communicable Disease Act 2015 in Region 6 Health Provider, 2018

Abstract

Situation Awareness Team (SAT), Office of Disease Prevention and Control 6 Chon Buri, was informed by the Disease Control Laboratory, Office of Disease Prevention and Control 6 Chon Buri, on a case of XDR-TB patient in its area. The patient will be tracked by Fast Track System for admitting into Hospital. Outbreak investigation is provided by local SRRT team within 12 hours for diagnosis, outbreaking, propagated source and setting disease control measure. This study is based on descriptive epidemiology by interviewing, medical record review, history of family or infection, interviewing participant, household contact or close contact, including environmental observation. The study found that the patient is male and works as employee and has no TB and diabetes treatment history before. In June B.E. 2561, he is taken to Community Hospital because of exhaustion, stomachache, three times vomit, 20kg weight lossing within three months, and five years of chronic cough but he buys medicine on his own. Laboratory result is abnormal (positive 2+ for AFB; CXR is bilateral patchy infiltration LUL cavity with infiltration.; DPC6 Laboratory finds all four drugs resistant (Streptomycin, Isoniazid, Rifampicin, Ethambutol) for DST and finds Mycobacterium Tuberculosis Complex Growth for Culture TB Sputum.; Molecular Assay shows SL-LPA (Second Line Drugs) MTB Detected. Both Fluoroquinolone and AG/CP show resistant.) Team monitors and isolates patient for XDR-TB treatment, while three household contacts and sixty-six close contacts are treated by CXR and sputum collection for IB. How patients access health care service is a great obstacle. Patients may misunderstand in their sickness and not to access good health care services, those people choose to buy themselves medicine easily. This result postpones TB diagnosis and treatment.