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TB/HIV COLLABORATION IN UGANDA

TB/HIV COLLABORATION IN UGANDA. PRESENTED BY DR HENRY LUWAGA. BACKGROUND. Population 25M Adult HIV Prevalence 6.1% PLWHA estimated to be 1M TB burden estimated at 150-160 smear positive cases per 100,000 50% of TB patients are HIV +ve There was need to improve care for TB/HIV clients.

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TB/HIV COLLABORATION IN UGANDA

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  1. TB/HIV COLLABORATION IN UGANDA PRESENTED BY DR HENRY LUWAGA

  2. BACKGROUND • Population 25M • Adult HIV Prevalence 6.1% • PLWHA estimated to be 1M • TB burden estimated at 150-160 smear positive cases per 100,000 • 50% of TB patients are HIV +ve • There was need to improve care for TB/HIV clients

  3. TB/HIV Collaboration in Uganda • TB/HIV joint communication strategy • TB counseling Included in the counselor training curriculum • TB/HIV care in an urban setting (Nsambya Hospital and Kiswa HC) (Staff oriented) • TB/HIV care at Health Subdistrict level in 2 Rural Districts (Kiboga and Pallisa) (Needs assessment done) • TB services in a VCT setting at the AIDS Information Centre (AIC) Kampala (Started 2001)

  4. EXPERIENCE IN A VCT SETTING

  5. CLIENT OFFERED VCT All HIV +ve and HIV -ve with TB symptoms Clinical assessment ZN, CXR TST Active TB Normal Latent TB Treatment SCC DOT Review after 1 year IPT

  6. PROGRESS • 7726 clients screened for TB Jan 2001 to March 2003 (156, 2% HIV –ve while 7570, 98% HIV +ve) • 533 (6.9%) declined further assessment. • 2131 (27.6%) excluded • 1534 (19.9%) Lost to follow up • 402 (5.2%) clients diagnosed with active TB • Latent TB cases 668 (8.6%) offered IPT • 1592 (20.6%) were Mantoux -ve

  7. LESSONS AND CHALLENGES • TB care is feasible in a VCT setting • Quality of counseling is a vital element for adherence • Support counseling should be continuous • Introduction of TB care increased motivation for VCT • Loss of clients during the screening process • It demanded more personnel and space for counseling, clinical care and lab • Scaling up the approach in the public health system (Training capacity, resources, infrastructure)

  8. ACKNOWLEDGEMENTS • AIC Management • Clients for cooperation • My colleagues at NTLP and STI/ACP • CDC for financial and Technical support • Organizers of this meeting for enabling us share this information

  9. THANK YOU

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