1. TB/HIV COLLABORATION IN UGANDA
PRESENTED BY
DR HENRY LUWAGA

2. BACKGROUND Population 25M Adult HIV Prevalence 6.1%
PLWHA estimated to be 1M
TB burden estimated at smear positive cases per 100,000
50% of TB patients are HIV +ve
There was need to improve care for TB/HIV clients

3. TB/HIV Collaboration in Uganda
TB/HIV joint communication strategy
TB counseling Included in the counselor training curriculum
TB/HIV care in an urban setting (Nsambya Hospital and Kiswa HC) (Staff oriented)
TB/HIV care at Health Subdistrict level in 2 Rural Districts (Kiboga and Pallisa) (Needs assessment done)
TB services in a VCT setting at the AIDS Information Centre (AIC) Kampala (Started 2001)

4. EXPERIENCE IN A VCT SETTING

5. All HIV +ve and HIV -ve with TB symptoms
CLIENT OFFERED VCT
All HIV +ve and HIV -ve with TB symptoms
Clinical assessment
ZN, CXR
TST
Active TB
Normal
Latent TB
Treatment SCC DOT
Review after 1 year
IPT

6. PROGRESS 7726 clients screened for TB Jan 2001 to March 2003
(156, 2% HIV –ve while 7570, 98% HIV +ve)
533 (6.9%) declined further assessment.
2131 (27.6%) excluded
1534 (19.9%) Lost to follow up
402 (5.2%) clients diagnosed with active TB
Latent TB cases 668 (8.6%) offered IPT
1592 (20.6%) were Mantoux -ve

7. LESSONS AND CHALLENGES
TB care is feasible in a VCT setting
Quality of counseling is a vital element for adherence
Support counseling should be continuous
Introduction of TB care increased motivation for VCT
Loss of clients during the screening process
It demanded more personnel and space for counseling, clinical care and lab
Scaling up the approach in the public health system (Training capacity, resources, infrastructure)

8. ACKNOWLEDGEMENTS AIC Management Clients for cooperation
My colleagues at NTLP and STI/ACP
CDC for financial and Technical support
Organizers of this meeting for enabling us share this information

9. THANK YOU