Kamwokya Christian Caring Community The Role of Treatment Supporters In TB Management. Being a Paper Presented at The XVIII International AIDS Conference, Held At Reed Messe Wien Vienna, Austria 18th -23 rd July 2010 Prepared by Seruma Nelson

Introduction Non-adherence to TB treatment is receiving considerable attention among HIV/AIDS implementers. Whereas the Ministry of Health developed different strategies to ensure adherence to TB treatment, including TB DOTS, and increased availability of drugs, There is lack of network systems among patients, families, and health institutions Most health centers dispense drugs but do not link up with the community for follow up on TB patients.

Methods Kamwokya Christian Caring Community Catchment area was divided into zones Lists of patients from each zone are produced and distributed among CHWs On clinic days TB patients are educated on: follow up on lab investigations, importance of completing treatment, role of expert supporters (CHWs), and consent to home visiting. On every visit to TB patients, treatment supporters fill forms collecting treatment data, and they help the patients fill in their treatment cards. Nurses make routine community follow up visits to support the patients and treatment supporters based on the TB CHW’s reports

Results 33 CHWs were identified and trained to follow up HIV/AIDS/TB patients Between , 238 patients were co-infected with HIV/TB. By the end of 2005, default rates averaged at 25%. This reduced to 19% in 2006, 11% in 2007, 10% in 2008, and 7% in 2009 among patients visited by CHWs (also see figure 1 below) By the end on 2009 an overall 639 (57.2%) patients had HIV/AIDS&TB out of an overall 1,117 TB patients ever enrolled on TB treatment

5 Results Continued In % out of 134 patients enrolled managed to produce a sputum for confirmatory tests, 3 died and the rest completed but failed to produce a sputum. Figure 1 Figure 2

Conclusion & Lessons Learnt Lessons Learnt: HIV/TB related stigma & discrimination Provision of Medical care to patients and family members. Inadequate nutritional support. Community sensitization on TB. TB Infection does not limit a patient from being in social gatherings. Multi-level family involvement. Conclusion: The success of TB treatment depended on the linkages between the KCCC clinic, communities, families, and CHWs. TB treatment should look beyond the Directly Observed Therapy (DOTS) Short Course approach, to more sustainable methods, like expert treatment supporters (CHWs).