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Missed opportunities to diagnose TB and HIV Co-infection in HIV workplace program

Missed opportunities to diagnose TB and HIV Co-infection in HIV workplace program. Dr Fred Mugyenyi Asiimwe Medical Director, ALAFA. Lesotho. Population: 1.8 million TB incidence is estimated at 640/100,0000 3 rd Highest HIV prevalence (23.6%) 78% of the TB patients are HIV infected.

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Missed opportunities to diagnose TB and HIV Co-infection in HIV workplace program

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  1. Missed opportunities to diagnose TB and HIV Co-infection in HIV workplace program Dr Fred MugyenyiAsiimwe Medical Director, ALAFA

  2. Lesotho • Population: 1.8 million • TB incidence is estimated at 640/100,0000 • 3rd Highest HIV prevalence (23.6%) • 78% of the TB patients are HIV infected

  3. Background • Labour intensive industry • Employs approx. 40,000 low- skilled, mostly female workers • Biggest employer in private sector • Sustains livelihoods of up to 450,000 Basotho • HIV prevalence among apparel workers 41% (ALAFA, Sept2009)

  4. Medical Monitoring HIV Mgt Care & Treatment Support Groups Counselling VCT PMTCT Peer Education Prevention Mobilisation STI IEC Condoms TA Policy & Management Buy-in Trainings Monitoring Implementation model

  5. ALAFA TB/HIV integration • PPP is instrumental in in helping countries realize their MDG goals • ALAFA role to detect TB cases early leads to universal care for TB care • ALAFA aimed to improve diagnosis, treatment and patient outcomes • Activities to reduce the burden of TB in PLWHA (the 3Is) • Activities to reduce the burden of HIV among TB patients (HTC, CPT, HIV care and support, ART)

  6. ALAFA PROGRESS SO FAR

  7. Summary of alafa tb & HIV integration results

  8. ALAFA TB/HIV progress Aug 200-Aug 2010

  9. Breaking barriers at the factory floor • Improved clinical care (early TB diagnosis in HIV infected person) • Improved HTC uptake • Improved efficiency and leverage of available minimal resources • Better patient adherence • Improved patient outcomes • Improved patient flow systems for TB/HIV co-infected patients • Awareness -Peer educator-TB and HIV • Non discrimination

  10. Workplace clinic is a one stop centre

  11. Weaknesses and gaps in the TB and HIV care services at the workplace • Inadequate TB diagnostic capacity • Trained health care personnel to provide quality services • TB prevention advocacy and social mobilization • Lack of operational research to inform policy on the role of PPP • Stronger M& E systems • Treatment adherence support

  12. Role of GBC/Government and Private sector partnerships • Resource mobilization –inadequate human and financial • Need for stronger M&E systems • Guidance documents • Measure and report on contributions of PPP • Extend the model to other service sectors and industries

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