DAPCU Bhadrak Response to DCC for HIV-TB

 1.      Advantages of DCC in HIV-TB collaboration activity 

10th DCC for HIV-TB meeting Chaired by Collector & DM on 27th Dec-12

• It is a gateway to review the HIV-TB activities on quarterly basis and to sort out the issues and analysis the gaps.
• It ensures the Target vs Achievement of cross referral of all ICTCs and DMCs.
• By conducting regular DCC meeting, it brings the importance among the DCC members to focus on TB-HIV activities.
• It also points out the gap of the TB-HIV activity and accordingly DAPCU makes the strategic planning for the better implementation.
• It creates a interpersonal relationship, well coordination among the members.
• It facilitates the members to take decision for the proper implementation of the TB-HIV activities in the District.

2.      Implementation of the National framework for TB – HIV Collaborative activities

            There are many instances that DAPCU through DCC has exercised its role for  
        strengthening the cross referrals and implementation of the National frame work for 
        TB-HIV collaborative activities. 

• Ensuring the referral by the support of Counsellors of ICTCs/LAC/STD Clinic/TI/DIC.
• Regular monitoring and supervision to both DMC & ICTC by DAPCU and Nodal Officer, AIDS and DTO also minimize the gaps.
• Regular monthly review cum co-ordination meeting on HIV-TB among the Counsellors- STS/STLS/nodal officers and other referral units in the district also strengthen the coordination and makes a platform to discuss various issues and gaps.
• Ensuring the increase of referrals in ICTC and DMCs by the DOTS Provider and ASHAs through discussions in the ASHA sector meeting by our ICTC counsellors.

   We expect the following results from our above approach and its happening also.

1. It will strengthen the referral system of on ART cases having TB symptoms in the LAC+.
2. It will ensure about the priority of TB treatment of PLHIV and any other opportunistic infections and need of CPT prophylaxis.
3. It will streamline the timely reporting system of TB-HIV and line listing.
4. It will reduce the TB prevalence in HIV and increase the rate of cure in TB treatment. 

3.      Measures to prevent TB & HIV 

• For prevention of TB in paediatric cases, INH tablet of 10 mg per Kg. Body weight is being provided.
• Monteux test is being provided to all suspected children having TB symptoms in all DMCs.
• The single use of disproven syringes and needles in DMC for Monteux test of the paediatric cases.
• To prevent the infection of TB accurate and exact algorithm of sputum container disposal is maintained through waste management system.
• Counselling to the symptomatic and diagnosed TB cases by using  the 10 point tools in ICTCs.
• Referral to all HIV +ve clients and suspected TB symptomatic cases to the DMCs from ICTC for sputum examination.
• Referral to DMC/ART Centre from LAC/ICTC the on ART TB symptomatic cases for further treatment.
• Priority on TB treatment first among on ART cases.
• Regular follow up to the co infection cases and MDR TB cases by the counsellor and ensuring the hygienic condition in ICTC for infection control of TB and other opportunistic infections.

4.      Role of ICTCs, ART, and Care & Support Centres in intensified TB case findings 

• Information/knowledge provided on TB/HIV and its impact on the community through counselling process to find out the TB suspected cases.
• Referral of suspected TB symptomatic cases to DMCs for Sputum examination.
• Referring of all HIV positive cases/co-infection cases for administration of CPT prophylaxis.
• Regular home visit to co-infection cases and consulting to the DOTS Provider to refer the contact persons of TB affected cases to ICTC and DMCs through outreach.
• Attending the TB-HIV co-ordination meeting.
• Providing the IEC materials on HIV-TB to the clients visiting to the ICTC.
• Using the cross referral signage board in both ICTC and DMC and OPD.
• Co-ordinating with TI/IDIC/STD Clinic/LAC for referral of suspected TB cases to ICTC and DMCs.
• As there is no ART, the Counsellor of LAC is referring the On ART TB symptomatic cases to ART & DMCs for  sputum examination and further treatment .
• Motivating the ASHAs and DP by the counsellor to refer the TB suspected cases to ICTC and DMC.

5.      Strategies for 100% treatment, care and support for TB– HIV co- infection cases

      On the above services provided in different facilities the DAPCU, Bhadrak is having the 
      following strategic planning for the implementation of TB-HIV activities in the Bhadrak 
      district.    

1. Regular monthly HIV-TB co-ordination meeting.
2. Regular quarterly DCC meeting on HIV-TB activities.
3. Monitoring and supportive supervision to different ICTCs to DMCs by DAPCU team/DACO/DTO in every month.
4. Maintaining a separate register for co-infection cases for better follow-up and treatment services.
5. Validation of HIV-TB line listing report and send the HIV-TB monthly compilation report to OSACS.
6. Ensuring the HIV-TB activities through convergence with other line departments in the District.
7. Lastly ensuring the 100% follow up to the all TB and HIV cases and ensuring the 100% pre ART registration of all HIV +ve cases through outreach activity.