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Haileyesus Getahun Stop TB Department WHO

14 th Core Group Meeting of the TB/HIV Working Group, Addis Ababa, Ethiopia. Re-conceptualizing ICF and IPT: global progress to date. Haileyesus Getahun Stop TB Department WHO. Collaborative TB/HIV activities. A. Establish the mechanism for collaboration A.1. TB/HIV coordinating bodies

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Haileyesus Getahun Stop TB Department WHO

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  1. 14th Core Group Meeting of the TB/HIV Working Group, Addis Ababa, Ethiopia. Re-conceptualizing ICF and IPT: global progress to date Haileyesus Getahun Stop TB Department WHO

  2. 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- Three Is B.1. Intensified TB case finding B.2. Isoniazid preventive therapy B.3. TB infection control in health care and other settings Joint HIV and TB HIV programme 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. TB programme

  3. Why re-conceptualisation?

  4. Countries with policy on ICF, 2006 (N=109) Countries reporting ICF, 2006 (N=44) Why re-conceptualisation?

  5. Countries with policy on IPT, 2006 (N=82) Countries reporting IPT, 2006 (N=24) Why re-conceptualisation?

  6. Essential package of HIV care and treatment ICF as a gatekeeper for IPT and Infection control Simplified screening algorithm (WHO) Implementation on the grounds of human rights Re-conceptualisation of IPT and ICF WHO's Three Is Meeting, April 2008

  7. Progress: Meta-analysis of primary data Primary question What is the most sensitive clinical algorithm to screen for culture-confirmed pulmonary TB in people living with HIV? Objective Develop a standardized evidence-based approach and guidelines to TB screening and prevention (IPT) among PLHIV.

  8. Progress: Meta-analysis of primary data Inclusion criteria for studies • Involved diagnosis of TB in PLHIV • Culture of at least one sputum specimen was used to confirm the diagnosis of TB • Sputum specimens were collected from PLHIV regardless of signs or symptoms • Data was collected about symptoms and signs in PLHIV at the time that sputum specimens for culture were collected

  9. Published and unpublished studies included in the meta-analysis

  10. Progress: Scaling up IPT as part of ICF • IPT statement of WG finalised and widely disseminated. • FAQ on IPT developed and will soon be posted on WHO website • Paper submitted to the Lancet • Summarise findings of global consultation • Simplified strategy of scale-up suggested • Critical steps for nationwide scale up identified • NTP to lessen its "control" over INH as a drug

  11. Progress: demand generation First ever protest at HIV Conference Mexico city, August 2008 Living with HIV. Dying of TB

  12. Conclusion • Evidence based TB screening and prevention approach in progress by WHO • Leadership and ownership from HIV stakeholders for IPT and ICF is needed • Countries need to scale up ICF, as a gateway for IPT and infection control • Dire need for increased community mobilisation and demand generation • More research, research, research for the best tool

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