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Dissemination workshop on Findings from the OPTICAM Study for Tuberculosis preventive treatment initiation for People Living with HIV in Cambodia

On March 27, 2024, the Institut Pasteur du Cambodge co-hosted with the National Center for HIV/AIDS, Dermatology and STD (NCHADS), the National Center for Tuberculosis and Leprosy Control (CENAT) and the Clinton Health Access Initiative (CHAI) a restitution workshop aiming at sharing the results of the OPTICAM research project and experiences in Latent Tuberculosis Infection (LTBI) Management.


The Opening Ceremony of the dissemination workshop of the OPTICAM Study results was attended by H.E. Dr. YOUK Sambath, Secretary of State, Ministry of Health, H.E. Dr. MAO Tan Eang, Undersecretary of state, Ministry of Health, H.E. Dr. SOK Srun, Director at Department of Hospital Services; H.E. Dr. MEAN Chhivun, Advisor of the Ministry of Health, Dr OUK Vichea, Director of NCHADS, Dr. KHUN Kim Eam, Deputy Director of CENAT, Prof. André SPIEGEL, Director of Institut Pasteur du Cambodge (IPC), Mr. SEAK Kunrath, Representative from CHAI, Dr. VU Van Chieu from the Vietnam Authority of HIV/AIDS Control, Ministry of Health in Vietnam, and the Directors / Deputy Directors of Provincial/Operational Health Departments, the Provincial HIV / AIDS TB Program Directors, Health Care workers and OI/ART staff representing the 25 provinces in Cambodia.


This workshop was attended by two hundred fifty participants with many expertise from all different provinces in Cambodia, and provided an opportunity to present the study results, as well as the CENAT LTBI standard of procedures, the NCHADS revised clinical guidelines, the tuberculosis preventive therapy (TPT) coverage data from NCHADS, and the experience from Vietnam. People living with HIV (PLHIV) and Health care workers working in OI/ART clinics shared their experience of TPT. A session was dedicated to scale up direction and plan.


The OPTICAM research project was led by the two national tuberculosis and HIV programs in Cambodia in collaboration with CHAI and the IPC with Dr Laurence BORAND, as the coordinating investigator of this project for the Institut Pasteur du Cambodge.


The general objective of this project was to improve the coverage of TPT in PLHIV. The first phase of this project identified the barriers to the initiation of TPT among PLHIV. Based on the identification of these barriers to TPT initiation, the second phase of the project consisted in developing a comprehensive intervention that would address these barriers and increase TPT coverage among people living with HIV/AIDS in Cambodia.      


The identified barriers included notably lack of knowledge and fear of side effects. Health care workers worried about lack of adequate training on LTBI and TPT, and too long treatment with the daily 6 months therapy with Isoniazid with possible issues on people adherence to treatment and drug stock-outs. They were also concerned over inability to rule out active TB in their patients.  An approach that was built and conducted with CENAT and NCHADS, including introduction of the short course 3 months weekly regimen named 3HP, comprehensive health care workers training and mentoring, reinforcement of drug management, and PLHIV information based on the previously identified barriers led to an increase in TPT coverage in PLHIV from 15% up 86% in adult PLHIV attending the HIV clinics.


This research project was made possible thanks to the support from L’Initiative Expertise France and the excellent collaboration between NCHADS, CENAT, IPC and CHAI.