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TB-HIV Collaborative Activities

TB-HIV Collaborative Activities. Debriefing and Discussion The 5 th Joint International Monitoring Mission National TB Program, Thailand 23 August 2013. Situation / Progress. HIV testing of TB patients much improved

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TB-HIV Collaborative Activities

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  1. TB-HIV Collaborative Activities Debriefing and Discussion The 5th Joint International Monitoring Mission National TB Program, Thailand 23 August 2013

  2. Situation / Progress • HIV testing of TB patients much improved • Increase from 76% in 2009 to 90% in 2011; >95% in 2012 in most facilities visited • Proportion of HIV+ patients started on cotrimoxazole preventive therapy (CPT) and anti-retroviral therapy (ART) improved but vary considerably by site • 40%-68% of eligible HIV+ patients started on CPT (target 90%) • 35%-57% of eligible HIV+ patients on ART (target >60%) • Formal coordinating mechanism for TB and HIV absent or not functioning at all levels • Intensified case finding for TB in HIV patients is routinely being done • >95% of HIV patients screened for TB in 2012

  3. Situation / Progress • Strong infection control programs in most facilities • One-stop TB clinics • Effective triage with fast tracking in outpatient departments (OPDs) • Well ventilated OPDs; negative pressure / isolation rooms available at most hospitals visited • Surveillance for TB in health care workers • Clinical management TB-HIV patients vary by clinician • Inconsistencies between HIV and TB guidelines • No use of isoniazid preventive therapy in HIV patients after TB has been excluded • Sensitive diagnostics not routinely used for TB case finding in TB-HIV patients except in Bangkok

  4. Recommendations • Establish and strengthen mechanisms for delivering integrated TB & HIV service • e.g., functional coordinating bodies at all level • Expand ART and CPT use in TB-HIV patient • ART for all regardless of CD4 count • CPT for all • Harmonize TB and HIV guidelines and improve communication with and training of clinicians • coordinate with medical associations to provide continuing medical education training • Review and strengthen IPT guidelines to ensure implementation

  5. Extra Slide

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