Integrated TB/HIV activities at community level promote TB cure rate
Humana People to People in partnership with FHI360 (the APC project) aims to intensify TB case finding among PLHIV, promote uptake of CTBC and contribute towards successful cure rates in support of the national Community TB Care strategy.
During community TB education and HIV prevention messaging, 94% of people were screened for TB using the intensified case finding methodology. Also all newly diagnosed PLHIV screened for TB who were presumptive TB were referred to facilities. Out of those screened for TB, 11% were presumptive for TB cases and were referred to the TB clinic for investigation. Among those who completed referrals to a TB clinic, 14% were diagnosed with TB and started on TB treatment, 49% were not diagnosed with TB, and 37% are awaiting their TB results. Mobility of communities is a major challenge to both complete referrals and to ascertain referral completion. 28% of the presumptive TB identified were offered community HTC services.
Meetings were held between health facilities and HPP to streamline the referral process. Intensive TB case finding was conducted systematically among PLHIV identified through community HTC. The CHWs screen all TB contacts, conduct health education on TB at household level and educate families on infection control at household level.
HPP’s TB programming includes support for clients on family DOTS. In the family supported model, the HPP Community Health workers (CHW) partner with families to monitor patient adherence to TB treatment biweekly. In addition, the CHWs remind patients about the monthly clinic follow up visits and sputum collection; and in some cases collect sputum at the community level to be analyzed at the health facility. This strategy has been well received leading to improvements in the implementation of CTBC activities. The number of TB patients enrolled in the CTBC program has increased consistentently in quarter three. Furthermore, HPP has been expanding its TB coverage to all health facilities in the districts.