Enhancing HIV Testing through HIV-TB Co-infection Integration

 {Photo credit: MSH staff.}A lab technician in the DRC’s Kasaï Oriental Province who received training on HIV-TB co-infection.Photo credit: MSH staff.

People living with HIV or tuberculosis (TB) face many health challenges, but when infected with both of these diseases, their struggles multiply, because each disease accelerates the other’s progression. The Democratic Republic of the Congo (DRC) is ranked eighth among countries reporting the highest rates of HIV/TB co-infection. To manage the burden of care at such a level, countries must have well-trained staff in a health system that takes an integrated approach to care and treatment.

Through the USAID-funded DRC-Integrated Health Project (DRC-IHP), the DRC is making strides in the provision of care and treatment for HIV-TB co-infection. Kasaï Oriental Province had the highest level of TB infection in the country in 2012, with 76 of every 100,000 residents infected, but only four out of the nine health centers supported by DRC-IHP offered detection and treatment for co-infection. People living with HIV are more likely than others to become sick with TB, and TB significantly reduces their life expectancy. Therefore, it is important to increase the capacity of the local health workforce to provide integrated services.

In 2012, DRC-IHP organized an extensive, five-day HIV-TB co-infection training for 10 doctors, 36 nurses, and 16 lab technicians, ensuring that all nine DRC-IHP supported health centers could offer integrated services. DRC-IHP also provided supplies for HIV and TB screening at the training’s conclusion, so that the centers had everything they needed to screen for both diseases. Subsequently, the project worked with the DRC Ministry of Health to provide supportive supervision for the newly trained staff, with regular refreshers about the importance of screening for both diseases as well as reminders about the best practices for putting people on treatment once they are diagnosed with either illness.

Six months later, the results showed that the HIV-TB co-infection activities in health centers enabled 674 tuberculosis patients to be tested for HIV from January to June 2013, as compared to 458 TB patients in the prior year, a 32 percent increase. The nurses in charge of the TB counseling reported that 95 percent of tuberculosis patients accepted HIV screening once they understood the benefits. Now, co-infected TB-HIV patients are placed directly on antiretroviral (ARV) treatment two weeks after the beginning of tuberculosis treatment.

Says health zone Nurse Supervisor Charles Madika:

The revitalization of HIV-TB co-infection activities allowed us to improve our services, particularly in finding tuberculosis patients living with HIV and AIDS and quickly getting them ARV treatment.