Issue: It looks like large number of TB/HIV co-infected cases are being continuously missed in the South-East Asia Region due to inadequacies in TB/HIV collaborative operations.
Project: Community DOTS and home based care programs are not sufficiently linked, hampering early TB case detection in PLWHA. PLWHA networks have overall poor TB orientation. Their representation in TB/HIV coordination bodies is limited. HIV C & T of TB cases is insufficient. TB case detection in HIV high risk groups (sex workers, IDUs) is inadequate. Private providers are not adequately sensitized to strategies and programs of TB/HIV collaboration.
Results: In 2009, only 14% of notified TB cases tested for HIV (N=316,000), 13% of tested was HIV infected. 75% and 52% HIV-infected TB patients started CPT and ART respectively. Only 9% of 3.5 million PLWHA of the region (N=310,000) were screened for TB and 5000 PLWHA put on IPT. HIV prevalence in new TB cases in South-East Asia ranges from less than 0 .1% in Bhutan to 17% in Thailand with average regional prevalence 5.7%.
Lessons learnt: TB/HIV collaboration must actively involve networks of PLWHA, sex workers, MSM/Transgender and IDUs, private providers and Community DOTS program to timely reach and support adequate number of co-infected cases within unified initiative.
Sugata Mukhopadhyay
(This abstract is submitted to ICAAP' 10 on behalf of UNIVERSAL Health)
