PREVENTION OF TB AMONG PEOPLE LIVING WITH HIV - by: Godday Aghedo

Tuberculosis (TB) is an airborne disease caused by my mycobacterium tuberculosis. It is one of the top causes of death in HIV infected persons; as an opportunistic infection (OI). TB care and prevention among people living with HIV (PLHIV) and HIV care and prevention among TB patients are still an urgent need. According to surveillance and survey data, world health organisation (WHO) estimates that 9.27 million new cases of TB occurred in 2007, of which 14.8% (approximately 1.37 million) were estimated as HIV positive. Africa has the highest burden of the TB and HIV co-epidemic with 37% of TB patients estimated to be HIV-infected. This accounted for 23% of the estimated HIV deaths in 2007.

Considering the aforementioned, urgent steps are needed to be taken in view of preventing TB among PLHIV. Though the prevalence and mortality rates have continued to decline globally, the pace is still slow. As a result, the 2015 targets of halting, reversing and halving the 1990 prevalence and mortality rates were not met. However, intensifying efforts at preventing and treating TB among PLHIV, is  

Promoting linkages between tuberculosis (TB) and human immunodeficiency virus (HIV) treatment and prevention programs in resource-constrained environments where both diseases are prevalent is essential to improve the diagnosis, treatment, and outcomes for patients affected by both diseases. In this article, we share insights based on our experiences supporting integrated TB and HIV service delivery programme, including intensified TB case finding, isoniazide preventive therapy, infection control, and initiation of antiretroviral therapy. 

Our experience indicates that successful integration of TB and HIV services in resource-constrained environments is feasible, although programmatic, infrastructural, and staffing challenges remain. Successful implementation of TB and HIV collaborative activities requires consideration of the realities that exist on the ground and the importance of tailoring interventions in a manner that enables their seamless introduction into existing programs that are often overwhelmed with large numbers of patients and a paucity of human and other resources.