VCT Centre Can Work for TB-HIV Co-infection: Jhapa Experience

VCT Centre Can Work for TB-HIV Co-infection: Jhapa Experience

Patients or clients can only be attracted to the services since service provided by VCT centre are really helpful for them rather than getting new unsolved problems them in their society.

– Nawaraj Subba

Background

The World Health Organization (WHO) estimates 11.4 million people are infected with both Mycobacterium tuberculosis and HIV in the world. The primary cause of death in those infected with HIV is from TB, not AIDS. Globally, the incidence of HIV-associated tuberculosis has been increasing since the beginning of the AIDS epidemic. It is expected to increase even further during the foreseeable future, especially in developing countries. In United States, an estimate says about two out of ten people who have TB is also infected with HIV.

In South East Asia Region the increasing incidence of HIV/AIDS may fuel the TB epidemic, which is the second hardest hit by the HIV-epidemic following sub-Saharan Africa. The incidence of both diseases is highest in the economically productive age groups (15-54 years), poses significant threats not only to health, but also to the social and economic development.

In Nepal HIV prevalence in adult incident TB cases pose 3.1% (WHO, 2007).  The estimated number of PLWHA by the end of 2005 was 75 000. Similarly, the estimated Prevalence Rate of adult (ages 15-49) LWHA by the end of 2005 was <0.5%.   The estimated number of Women aged 15 and up LWHA was 16 000 and estimated No. of deaths due to AIDS during 2005 was 5100 (UNAIDS 2005).

Major TB and HIV/AIDS indicators in Jhapa

Analysis and Discussion
In Jhapa total current number of TB cases under treatment is 510. 15 TB patients have also infected with HIV infection. This number has been reported by health workers from DOTS and VCT centres. There is no reporting and analysis system of co-infected cases yet in health management information system. The number of clients coming for counseling was 8241 and among them 7022 has tested voluntarily for HIV. 210 clients have HIV positive that means prevalence rate was 3% among voluntarily tested population. 6 New AIDS patients added and 7 AIDS patients died in the year 2065/66 in Jhapa.

There are 21 DOTS centres and 6 VCT centres in Jhapa. Most of the DOTS centres are run by government health institutions whereas most of the VCT centres are run by non governmental organizations. One of the common barriers for TB patients or HIV infected person is still a stigma of being disclosed. They are reluctant to go for laboratory diagnosis whether they are having co-infection or not. At that time a VCT centre can play a major role and it could be a helpful place or centre for the patients. Patients or clients can only be attracted to the services since service provided by VCT centre are really helpful for them rather than getting new unsolved problems them in their society.

Recommendation
Both patients and health workers have experienced as VCT centres needs to have quality service in terms of counseling and follow up services. In the absence of having follow up service VCT wouldn’t be able to attract people for voluntary testing. District Public Health Office Jhapa has made its efforts to expand VCT centres up to target groups and also for strengthening of follow up services in all VCT centres.

Reference:
1. DPHO (2008/9). Annual Report and DACC Bulletins published by District Public Health Office Jhapa Nepal

2. DOHS. Annual Reports. Department of Health Services, Kathmandu Nepal.

3. NIAID (2010). National Institute of Allergy and Infectious Disease, AIDS and TB infections.

4. S. Preetish et. al (2003). TB-HIV co-infection I India, NTI Bulletin 2003, 39/3&4, 11-18.
5. Science Daily (2010). Alarming New Data Shows TB-HIV Co-Infection A Bigger Threat.

6. WHO (2010). World Health Organization, Joint HIV/TB interventions. Retrieved on Nov 04, 2009 from www.who.int/en

7. UNAIDS, Global Fund projects that UNAIDS’ call for elimination of mother–to-child HIV transmission by 2015 is within reach. Retrieved on Nov 04, 2009 from www.unaids.org/en