Assessment of national tuberculosis and HIV collaborative program implementation status in health care settings of Ethiopia (original) (raw)
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TB and HIV Epidemiology and Collaborative Service: Evidence from Ethiopia, 2011–2015
HIV/AIDS (Auckland, N.Z.), 2020
Background Integrating and scaling up tuberculosis (TB) and HIV services are essential strategies to achieve the combined goals ending both TB and HIV, especially in TB and HIV high burden countries. This study aimed to examine the prevalence of TB and HIV co-infection and the implementation of collaborative services in Ethiopia. Methods We used a national sentinel surveillance TB/HIV co-infection collected between 2010 and 2015. The Ethiopian Public Health Institute collected and collated the data quarterly from 79 health facilities in nine regional states and two city administrations. Results A total of 55,336 people living with HIV/AIDS were screened for active TB between 2011 and 2015. Of these, 7.3% were found co-infected with TB, and 13% TB-negative PLWHA were on isoniazid preventive therapy. Nine out of ten (89.2%) active TB patients were screened for HIV counselling and 17.8% were found to be HIV positive; 78.2% and 53.0% of HIV/TB co-infected patients were receiving cotrimo...
Evaluation of collaborative TB/HIV activities in a general hospital in Addis Ababa, Ethiopia
BMC Research Notes, 2012
Background: Ethiopia has had mechanisms for TB/HIV collaborative activities since 2002. However, no published account has defined the role of these collaborative efforts in strengthening linkages between HIV and TB management units at the point-of-care level. Our objective was to assess the extent of linkages between the two programs at the patient management level at Zewditu Memorial Hospital in Addis Ababa, Ethiopia. Between January and December 2008, the registers of 241 TB patients were reviewed to determine the HIV testing rate, the treatment charts of 238 randomly selected patients were reviewed for providers' compliance with evaluation criteria, and exit interviews were conducted with 309 TB/HIV co-infected clients to validate providers' compliance. Results: From register review, it was determined that the HIV testing acceptance rate was 95%, and that 70% of patients received post-test counseling. A review of the patient chart revealed that of 51 patients with a complaint of cough, duration for cough was recorded in 35 (68.6%) cases and cough > 2 weeks was recorded in 25 (49.0%) cases. Seventy two percent (18 of 25) were linked for sputum microscopy. Linkage to cotrimoxazole prophylactic treatment was 81%, but only 47% of eligible patients were linked to isoniazid preventive therapy (IPT). Correct diagnosis was accomplished at a rate of 100% for smear positive pulmonary TB, 23% for smear negative pulmonary TB and 88% for extra pulmonary TB patients. Both chart review and exit interviews indicated that history of TB contact and cough > 2 weeks predicted TB disease.
International Journal of Infectious Diseases, 2018
Background: Globally, HIV and tuberculosis (TB) are a leading cause of death if they occur as comorbidities in affected individuals. The aim of this study was to evaluate the collaboration between TB and HIV control activities by determining the co-morbidity rate in Oromia Region, Ethiopia, during the period 2009-2015. Methods: A retrospective health facility-based study was conducted. Data were collected from health facilities implementing the directly observed treatment short-course (DOTS) strategy in the region. A structured World Health Organization (WHO) reporting format was used as the data collection tool. Preantiretroviral therapy (ART)/voluntary counselling and testing for HIV (VCT) and TB unit registers were considered as the data sources. Data were collected quarterly and analyzed using IBM SPSS Statistics version 20. The odds ratio was used to assess statistical differences among variables. Results: A total of 115 268 TB patients were counselled and tested for HIV during the study period. Among the patients tested, 60 086 (52.1%) were male, of whom 13 680 (11.8%) were found to have an HIV infection. Among TB patients who were co-infected with HIV, there were slightly higher odds of HIV infection in females than in males (odds ratio 1.13, 95% confidence interval 1.09-1.17). Between 2009 and 2013, about 56% of TB and HIV co-morbid patients were put on co-trimoxazole preventive therapy (CPT) and 35% on ART. HIV infection occurred predominantly within the age group of 25-34 years (31%). On the other hand, 197 152 HIV-infected patients were screened for TB symptoms and 8.4% were found to have active TB. The odds of having TB among males who were initially infected with HIV were higher as compared to females (odds ratio 1.31, 95% confidence interval 1.27-1.37). Conclusions: The prevalence of TB and HIV co-morbidity was 11.8% at TB clinics in the region. Low proportions of co-infected patients were put on CPT and ART. Therefore, it is essential to strengthen the WHO recommended TB and HIV collaborative activities in the region to reduce the burden of comorbidity and mortality.
Open Journal of Epidemiology, 2016
Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods; we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients; whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don't have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don't have MultiDisciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: * Corresponding author. being females TB patients was 86% lower than their counter part males (AOR = 0.14; 95% CI = 0.04-0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16; 95% CI = 0.49-0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn't get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.
Evaluation of TB/HIV Collaborative Activities: The Case of South Tongu District, Ghana
Tuberculosis Research and Treatment
Background. There is a complex interaction between infection with human immunodeficiency virus (HIV) and tuberculosis (TB) infection that results in a synergistic increase in their prevalence, morbidity, and mortality. In Ghana, 32% of TB cases were estimated to be coinfected with the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic HIV, with the highest number of coinfections in the Volta Region. This study assessed the extent of linkage between the TB and HIV collaborative activities in the South Tongu District of Ghana. Method. The study employed both qualitative and quantitative methods to assess the coverage of activities to reduce the burden of TB in people living with HIV and the coverage of activities to reduce the burden of HIV in TB patients and explored the barriers to collaborative activities from the providers’ perspective. Results. The study showed that 344 (94.8%) HIV-positive clients were screened for TB, of which 10 (8.5%) wer...
PLOS ONE, 2020
Objective To determine the yield of tuberculosis (TB) and the prevalence of Human Immuno-deficiency virus (HIV) among key populations in the selected hotspot towns of Ethiopia. Methods We undertook a cross-sectional implementation research during August 2017-January 2018. Trained TB focal persons and health extension workers (HEWs) identified female sex workers (FSWs), health care workers (HCWs), prison inmates, homeless, internally displaced people (IDPs), internal migratory workers (IMWs) and residents in missionary charities as key and vulnerable popuaiton. They carried out health education on the importance of TB screening and HIV testing prior to recruitment of the study participants. Symptomatic TB screening and HIV testing was done. The yield of TB was computed per 100,000 background key population. Results A total of 1878 vulnerable people were screened, out of which 726 (38.7%) presumptive TB cases and 87 (4.6%) TB cases were identified. The yield of TB was 1519 (95% CI: 1218.1-1869.9). The highest proportion (19.5%) and yield of TB case (6,286 (95% CI: 3980.8-9362.3)) was among HCWs. The prevalence of HIV infection was 6%, 67 out of 1,111 tested. IMWs and FSWs represented 49.3% (33) and 28.4% (13) of the HIV infections, respectively. There was a statistically significant association of active TB cases with previous history of TB (
International Journal of Health Sciences, 2017
Objective: Globally, the number of people living with human immunodeficiency virus (PLHIV) particularly in sub-Saharan Africa is growing. This has been resulted in increased number of tuberculosis (TB) new cases. To control burden of TB among PLHIV, a number of collaborative TB/HIV activities were recommended. However, data about collaborative TB/HIV services in the study area is scarce. The objective of this study is to assess intensified TB case finding, implementation of isoniazid preventive therapy (IPT) and associated factors among PLHIV. Methods: A facility based cross-sectional study design was employed among 419 randomly selected PLHIV from public health facilities of Harari region. Systematic sampling method was used to obtain sample from each health facilities. Interviewer-administered questionnaire was used to collect data. Data were entered into EpiData and analyzed by SPSS statistical software. Multivariate logistic regression analysis was conducted to determine the pre...
BMC Public Health, 2014
Background: Activities to decrease the burden of tuberculosis (TB) among people living with HIV (PLHIV) include intensified TB case-finding (ICF), Isoniaizid (INH) preventive therapy (IPT) and infection control in health-care and congregate settings (IC). Information about the status of collaborative TB/HIV care services which decreases the burden of TB among PLHIV in Ethiopia is limited. The purpose of the study was to assess TB case finding and provision of IPT among PLHIV in Addis Ababa. Methods: A cross sectional, facility-based survey was conducted between June 2011 and August 2011. Data was collected by interviewing 849 PLHIV from ten health facilities in Addis Ababa. Both descriptive and inferential statistics were used to analyze findings and the results are described in this report. Results: The proportion of PLHIV who have been screened for TB during any one of their follow-up cares was 92.8%. Eighty eight (10.4%) of the study participants have been diagnosed for TB during their HIV follow-up cares. PLHIV who had never been diagnosed for TB before they knew their positive HIV status were nearly four times more likely to be diagnosed for TB during follow-up cares than those diagnosed before (AOR [95% CI]: 3.78 [1.69-8.43]). Nearly a third (28.7%) of all interviewed PLHIV self reported that they had been treated with IPT. Conclusions: It can be concluded that ICF for TB and IPT among PLHIV in Addis Ababa need boosting. Hence, it is recommended to put into practice the national and global guidelines to improve ICF and IPT among PLHIV in the city.
Implementation of the Revised Guideline on TB/HIV Collaborative Activities in Lagos, Nigeria
International Journal of TROPICAL DISEASE & Health, 2015
The National Tuberculosis and Leprosy control programme commenced the implementation of the revised national tuberculosis/human immunodeficiency virus (TB/HIV) guideline in line with the recommendations from the World Health Organization in January 2013. This study evaluated the effect of the revised guideline on the implementation of TB/HIV collaborative activities geared towards reducing the burden of HIV in TB patients in Lagos, Nigeria. Methods: Retrospective review of presumptive and TB cases managed in TB treatment centers of Daniel et al.; IJTDH, 9(4): 1-7, 2015; Article no.IJTDH.18982 2 the Lagos State TB and Leprosy control programme between January 1 st to December 31 st 2012 (pre implementation period) and January 1 st to December 31 st 2013 (post implementation period). Analysis was done using Statistical Package for Social Sciences (SPSS) version 19. Results: Of the 19,533 presumptive TB cases registered during the pre implementation period 17,530 (89.7%) were offered HIV counseling and testing (HCT) out of which 15,247 (87%) accepted to be tested and 20.9% of those tested for HIV were positive. However in the post implementation period, of the 22,721 presumptive TB registered cases, 20397 (89.8%) were offered HCT and 19,264 (94.4%) accepted to be tested. Of those that were tested, 4430 (23%) were HIV positive. The proportion of TB/HIV co-infected patients enrolled on co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) during the pre and post implementation period were 76.6% vs 88.2% and 39.1% vs 49.8% respectively at p<.05. Conclusion: There was increase in the uptake of HIV testing, ART and CPT post implementation of the guideline. Sustaining the gains of policy implementation is of utmost importance.