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Progress with intensified TB Case Finding in Nigeria. Dr. E.B.A. Coker MD, MPH Coordinator National HIV/AIDS Programme. Presentation outline. Country information. HIV/AIDS profile. TB burden. Progress with intensifying TB case findings Challenges. Conclusion. Country Information.

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slide1

Progress with intensified TB Case Finding in Nigeria

Dr. E.B.A. Coker MD, MPH

Coordinator National HIV/AIDS Programme

presentation outline
Presentation outline.
  • Country information.
  • HIV/AIDS profile.
  • TB burden.
  • Progress with intensifying TB case findings
  • Challenges.
  • Conclusion.
country information
Country Information
  • Situated in West Africa.
  • Pop – 140M. (2006 census)
  • Federation of 36 states and FCT.
  • 774 LGAs.
  • 6 Geo Political zones
  • 927,000 sq m - Area
  • Presidential system of government
  • Health is on concurrent legislative list (NCH)
nigeria hiv aids profile
NIGERIA: HIV/AIDS PROFILE
  • HIV Prevalence (2005) 4.4%
  • Estimated Total PLWHAs 3m
  • PLWHAs Needing Treatment over 500,000
  • Number of PLWHAs on ARV by June 2008 234,030 (15,104 - children)
  • Cumulative No of Deaths 1. 45 m.
nigeria tb burden
Nigeria – TB burden
  • Nigeria currently ranked 5th among the 22 high TB burden countries
  • Estimated incidence for all cases is 311per 100,000 pop. (about 430,000 cases annually)
  • Estimated incidence for SM+ cases is 137 per 100,000 pop
  • Estimated prevalence of MDR-TB among new TB cases is 1.9%
  • TB burden is further compounded by high HIV prevalence
  • Prevalence of HIV among TB patients 27%
strategies for strengthening intensified tb case finding
Strategies for strengthening Intensified TB case finding
  • Co-location of DOTS and HIV services.
  • Expansion of DOTS services to prisons and military barracks.
  • Screening for symptoms and signs of TB among clients at HIV service delivery centers
  • Early identification of signs and symptoms of TB.
  • Diagnosis and prompt treatment of TB.
question in the screening tools routine screening by hcws of plwhas on a scale of 0 1
Question in the Screening tools (Routine screening by HCWs of PLWHAs on a scale of 0-1)

Health providers at HCT centres on Client intake form ask for:

- Cough >3 weeks

- Fever >3 weeks

- Night sweats

- Unexplained weight loss >= 3 Kg in last 4 weeks

- Haemoptysis (coughing up blood or blood-tinged sputum)

- Enlarged lymph nodes (>2 cm)

- History of TB

- Contact with a person with TB disease

linking intensifying case finding to ipt
Linking Intensifying case finding to IPT
  • National Policy for IPT for PLWHAs available.
  • IPT only for PLWHAs without active TB with no contraindication to INH.
  • Supply of INH for IPT among PLWHAs inadequate.
  • Linkage of PLWHAs (without active TB and contraindication to INH) to IPT still inadequate.
progress other component of the 3 is
Progress – “other component of the 3 Is”
  • National TB infection control Guidelines adapted.
  • SOP for TB infection control adapted.
  • Plan on to support trainings of State Programme managers and GHWs on TB-IC
challenges
Challenges
  • Weak systems for data collection, transmission and feed back.
  • Atypical presentation of TB in advancing HIV disease making diagnosis of TB difficult.
  • Inadequate linkage of Intensifying TB case findings to IPT.
conclusion
Conclusion
  • Nigeria’s TB burden is compounded by high HIV prevalence
  • National strategic framework for strengthening Intensified TB case finding.
  • National Policy for IPT for PLWHAs (without active TB with no contraindication to INH) available.
  • Linking PLWHAs to IPT still inadequate (?supply of INH)
  • Progress is being made with implementation of TB-IC (as a component of 3 Is)
  • Access to HCT services by TB patients
appreciation
Appreciation
  • ILEP(GLRA, DFB, NLR, TLMN)
  • USG (USAID, CDC, IHVN, MSH, AIDS relief, ICAP-Columbia, APIN)
  • CIDA
  • GFATM
  • WHO.
  • NEPHWAN.
slide21

Thank you!

for listening

TB HIV collaboration will lead us to beneficial health outcomes