There were at least three governmental abstracts on TB/HIV accepted in Toronto. Here are two of them.
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Role of outreach workers in TB/HIV patients
CDD1124
W. Naing1, S.S. Aye21National TB Program, Mawlamyaing, Myanmar, 2CARE Myanmar, Health, Yangon, Myanmar
Issues: TB-HIV dual infection is common and TB is the main life terminating opportunistic infection for PLHAs. Treatment compliance is crucial not only for cure but also for prevention and transmission of multi-drug resistance strain. Many PLHAs are reluctant to reveal their status and are often inaccessible and defaulters on TB treatment..Proper supervision, assistance, encouragement and monitoring are important for effective treatment of TB.
Description: Referral system with government TB Team were established in all CARE HBC sites in Mon ( 3 townships)and OWs were trained to implement and supervise the treatment. Technical knowledge on TB and other OIs were given to the PLHA self help groups. Regular monitoring and supervisory home visits were made during the 6 to 8 months treatment period. For 103 cases, OWs had 470 visits to TB center. PLHAs from self help group also participated in referral.
Lessons learned: 103 PLHAs were referred and 87 were found to be TB positive and they were treated with DOTS program. 14 % in 2004 and 27% in 2005 were sputum positive and the others were diagnosed by chest X-ray. Cure rate for sputum positive was 100% compared to 64% for general population. There was no defaulter compared to 5% for general population. Complete rate for sputum negative was 92% in 2004 and 81% in 2005. These impacts are due to the dedicated efforts of OWs and PLHS-SHGs and public-private partnership.
Recommendations: Supervision for treatment compliance by outreach workers is crucial and efforts to maintain the involvement of volunteers and family members should also be maintained.
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Synergistic outcome of national AIDS program and national tuberculosis program: HIV/TB sentinel surveillance survey (2005)
CDC0485
M. Thwe1, A.M. Soe1, W. Maung2, T. Lwin2, T. Aung11National AIDS Program, Department of Health, Yangon, Myanmar, 2National TB Program, Department of Health, Yangon, Myanmar
Background: HIV has imparted dramatic impact on burden of TB. It has also augmented the mortality of general population. HIV prevalence survey among TB patients was initiated during 1995 through 1997 with joint effort of National AIDS and TB programmes. But, due to limited resources it was not continued. Since HIV/TB problem is a growing problem, with the support of WHO, HIV/TB surveillance was reintroduced in 2005.
Methods: A cross-sectional survey was conducted in four pilot sites during October to December 2005. Blood was collected from 150 patients attending at TB clinics using unlinked anonymous approach. HIV antibody testing was done in National Health Laboratory (Yangon) and Public Health Laboratory (Mandalay).
Results: The protocol adequately works in the implementation. The prevalence rate of HIV and TB co-infection was found to be highest in Pyay (16.67%) and lowest in Hpa-an (3%) but 11.33% in Yangon whereas in Nyaung-U the rate was 9.09%. The overall rate was 10.4%. The majority (21.42%) of affected HIV infection was found in the age of 30-34 years.
Conclusions: Although findings from the sentinel surveillance survey do not represent the actual problem size, the findings of current study can be utilized as baseline data for the future program planning. They could be useful in monitoring the temporal trends of HIV infection in persons co-infected with TB and HIV. It also helps in better understanding to the HIV epidemic among TB patients. The finding can also be used in calculating the ART and Opportunistic Infection needs in the country.
