We integrate TB case finding with HIV testing and counseling services in high TB burden countries.
Integrating PSI’s HIV and tuberculosis (TB) interventions in countries with high burdens of HIV and TB.
Tuberculosis is the number one killer of people living with HIV (PLHIV), causing more than one-third of all HIV-related deaths. Cost-effective interventions such as symptomatic screening of all PLHIV, and provision of TB preventive therapy for PLHIV without TB symptoms, can reduce treatment delays for PLHIV with active TB. It can also significantly reduce the risk of developing TB for those with HIV – especially during the period immediately before and after antiretroviral therapy (ART) initiation. Despite the clear benefits of HIV/TB integration, in 2015 only 55% of all notified TB patients globally received an HIV test, and less than 80% of TB patients living with HIV were on ART.
To improve health outcomes for our clients in high TB/HIV burden countries, PSI has intensified our TB case-finding efforts by integrating TB screening in our HIV testing and treatment activities throughout Africa and Asia. Individuals with symptoms suggestive of TB are linked to quality-assured diagnostic services in the public or private sectors. Increasingly, PSI are providing these diagnostic services directly rather than requiring an external referral, and this has reduced treatment delays and loss-to-follow-up. Where we offer antiretroviral treatment for HIV, we are also working to provide quality-assured TB treatment and TB preventive therapy.
Making a Difference
In Zimbabwe, we ensure TB case detection among people living with HIV by integrating TB diagnostic services into our HIV testing services offered through our New Start social franchise. Thanks to funding from TB REACH in 2011, PSI/Zimbabwe is able to diagnose TB using the latest technology, including the GeneXpert MTB/RIF sputum test for diagnosing pulmonary tuberculosis. To further expand access to these quality diagnostics, sputum samples collected during outreach activities in rural areas are also processed at these centers. Since 2011, more than 1.3 million clients have been screened for TB symptoms with 37,200 having symptoms of TB and 3,410 clients confirmed to have active TB. Clients with active TB are notified of their results by phone or through in-person visits and almost 95% of those clients initiated treatment in the public sector.