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Interim Policy on Collaborative TB/HIV Activities

Interim Policy on Collaborative TB/HIV Activities. Adapted from Haileyesus Getahun Stop TB Department WHO. Overview. Introduction - rationale - purpose of policy - target audience Goal and objectives of policy Recommended TB/HIV collaborative activities

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Interim Policy on Collaborative TB/HIV Activities

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  1. Interim Policy on Collaborative TB/HIVActivities Adapted from Haileyesus Getahun Stop TB Department WHO

  2. Overview • Introduction - rationale - purpose of policy - target audience • Goal and objectives of policy • Recommended TB/HIV collaborative activities • Threshold to start the recommended TB/HIV collaborative activities

  3. Introduction • Rationale: because of the challenges HIV presents in control of TB at all levels, the policy was developed to be used with the strategic framework to assist policy makers determine what should be done decrease TB/HIV. • Purpose: to promote enhanced collaboration between TB and HIV/AIDS programs in providing care and service delivery to PLWH and those with or at risk of TB.

  4. Introduction • Target audience: For decision makers in the field of health for TB and HIV/AIDS , program managers in the health sector, as well as Donors, Development agencies and NGOs supporting TB and HIV/AIDS programs.

  5. Goal To decrease the burden of TB and HIV in dually affected populations.

  6. Objectives • Establish the mechanisms for collaboration between TB and HIV/AIDS programmes. • Decrease the burden of TB in PLWHA. • Decrease the burden of HIV in TB patients.

  7. Collaborative TB/HIV activities A. Establish the mechanism for collaboration A.1. TB/HIV coordinating bodies A.2. HIV surveillance among TB patient A.3. TB/HIV planning A.4. TB/HIV monitoring and evaluation B. To decrease the burden of TB in PLWHA B.1. Intensified TB case finding B.2. Isoniazid preventive therapy B.3. TB infection control in care and congregate settings C. To decrease the burden of HIV in TB patients C.1. HIV testing and counselling C.2. HIV preventive methods C.3. Cotrimoxazole preventive therapy C.4. HIV/AIDS care and support C.5. Antiretroviral therapy to TB patients.

  8. B. To decrease the burden of TB in PWHB.1. Intensified TB case finding • Screening for TB symptoms and signs. • Advantages: • interrupts TB transmission by identifying infectious cases • prevents mortality • decreases risk of nosocomial TB transmission • offers the opportunity to provide TB preventive therapy • improves TB case detection • Previously undiagnosed active TB was detected in up to 11% of PLWHA in VCT centres. Decrease the burden of TB in PLWHA

  9. B.2.Isoniazid preventive therapy • Given to individuals with latent infection with Mycobacterium tuberculosis. • Reduce short term risk of developing active TB in 64% of the PWH in high TB burden settings and by 40-64% in PPD positive individuals. • Is complicated because: • difficult identification of HIV-positive subjects • screening to exclude active TB • treatment adherence • Individual health rather than public health measure Decrease the burden of TB in PLWHA

  10. Administrative measures early diagnosis and treatment separation of PTB suspect Environmental measures maximise natural ventilation UV radiation Personal measures protection of PLWHA IPT cough etiquette B.3.TB infection control in health care and congregate settings Decrease the burden of TB in PLWHA

  11. Recommendations to start collaborative TB/HIV activities

  12. Criteria Recommendation I National adult HIV prevalence rate 1% OR National HIV prevalence among tuberculosis patients is  5%. All activities in A, B and C A. Establish mechanism B. Decrease TB in PWA C. Decrease HIV in TB [All 12 activities] Areas with 1% adult HIV as in Category I [ 12 activities] Other parts of the country as in category III. [ 4 activities] National adult HIV prevalence rate below 1% AND Administrative areas with adult HIV prevalence rate 1% II National adult HIV prevalence rate below 1% AND No administrative areas with adult HIV prevalence rate  1% A.2. HIV surveillance in TB B.1.TB case finding in PWA B.2. IPT in PWA B.3. TB infection control III

  13. Group work • According you, what is the policy saying and what is it important? • Who is responsible for these activities in your community/ region/ country? • How should these activities be undertaken at community, regional and national level? • As an activist to whom should you be targeting your advocacy plan to get them in place/ implemented?

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