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The goal of this addendum is to help management and staff minimize the risk of TB transmission at facilities in resource limited settings in which a.) HIV-infected persons receive diagnosis, care..., treatment, and/or support, and b.) there is a high prevalence of HIV infection, both known and undiagnosed, in settings such as prisons, jails, other detention centers, and drug rehabilitation centers. more
This regional advocacy strategy on HIV and AIDS, tuberculosis (TB) and sexually transmitted infetions (STIs) is intended for use by Southern African Development Community (SADC) Member States at a n...ational level. This is an overall advocacy strategy highlighting the most important issues relating to HIV and AIDS, TB and STIs in the Southern African region. It provides a broad advocacy framework for each of the issues identied, along with key targets, messages, and interventionsmore
This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal health, child health..., and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction of community-based provision of Family Planning through community health workers. In addition, the expansion of adolescent sexual and reproductive health programs is a pillar of this policy that will help attract and retain the next generation of Family Planning users. These efforts are anticipated to trigger a paradigm change in the way Family Planning services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all. more
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.more
Module 9
Strategic planning
July 2017
Module 9: Strategic planning. As WHO recommends offering PrEP to people at substantial HIV risk, this module offers public health guidance for policy-mak...ers on how to prioritize services, in order to reach those who could benefit most from PrEP, and in which settings PrEP services could be most cost-effective.more
Women and Health Initiative Working Paper No. 1. Women and Health Initiative Improving maternal health in the context of the sub-Saharan African HIV epidemic requires greater understanding of the relationships between ...ghlight medbox">HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge.
more
Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIVmore
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth ...most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.more
Policy brief based on the 2007 Rwanda Service Provision Assessment (RSPA) survey. The 2007 RSPA survey describes how the formal health sector in Rwanda provides services for family planning, maternal health, child health, malaria, ...bute-to-highlight medbox">HIV/AIDS, and other communicable diseases.
more
Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(...">TB) patients. Objective: To assess whether differences in gender and HIV
status affect diagnostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
more
The goal of this assessment is to determine how far USAID/Senegal’s HIV/AIDS and TB programs have achieved their specific objectives with regard to identifying potential leads for improvement that... are likely to make it easier to reach the planned results. After responding to the issues developed in various themes of the assessment, the results are placed in context and specific conclusions to each component are provided. The assessment also identifies the lessons learned from USAID/Senegal’s HIV/AIDS and TB programs and provides recommendations for future intervention.more
END TB
Second Meeting of th WHO Global Coordination Mechanism (GCM/NCD) Working Group on the inclusion of NCDs in other programmatic areas.
Accessded December 2017
Цель этого документа – повысить уровень осознания актуальности приоритетных направлений научных исследований по проблеме ТБ/ВИЧ (то есть по тем направлениям, кот...орые требуют срочного финансирования и внимания ученых), содействовать координации информационно-пропагандистской работы и стимулировать финансирование научных изысканий. Поставленная задача заключается в наращивании темпов осуществления высококачественных и интегрированных вмешательства по борьбе с ТБ/ВИЧ в условиях ограниченных ресурсов. В документе дается описание пересмотренной повестки дня по приоритетным научным вопросам, в основе которой лежат недавно полученные фактические данные по шести ключевым проблемам коинфекции ТБ и ВИЧ.more
The SAARC Member States have more than an estimated 2.0 million TB cases accounting for close to one-third of the total cases of TB in the world. India alone had almost one-fifth of the global disea...se burden due to TB. India, Pakistan and Bangladesh followed by Afghanistan are the major contributors of disease burden of TB in the SAARC Region. They are countries that have a dubious distinction of being on the list of 22 TB High Disease Countries in the world.more
Rev Panam Salud Publica. 2021;45:e74.
Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians’ and nurses’ knowledge about MDR-TB must ...be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome.more
Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and... recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP), which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more