DAPCU Phek Response to DCC for HIV-TB

Aadvantages of DCC in HIV-TB collaboration activity 

• Data sharing takes place which helps in cleaning data between the two offices.
• District specific issues can be solved during the meetings.

Strengthening of TB – HIV Collaborative activities 

• Taking the example of Phek district, initially referrals from RNTCP to ICTC was very low, but the data of this financial year shows that 90% of TB patients have been referred to ICTC for HIV testing. However, very sadly referrals from ICTC to RNTCP was very low; justification being that symptoms of TB could not be observed in clients entering ICTC first. It has also been learned that most of the clients are referred to RNTCP by OPD doctors.
• During one such meeting, we felt the need to be oriented on TB symptoms and therefore the DTO presented on such a topic to all the ICTC counsellors. To scale up referrals from ICTC-RNTCP, it has been decided that at least 10% of the total clients will be referred to RNTCP.
• One of our ICTC centres is not attached to any DMCs and therefore referrals to RNTCP were not taking place in that particular centre. In this situation, we linked the clients to the nearby DMC giving responsibility to the ICTC counsellor attached to it and therefore tracking of referred clients became easy. 

Intensified TB case findings in Phek District

During one such HIV-TB co-ordination meeting, we were introduced to a NGO identified by RNTCP wherein the particular NGO collects sputum during their outreach and when found TB positive, they are referred to ICTC for HIV testing. Targeted Intervention (HIV) NGOs also collect sputum from their clients and sent the samples to RNTCP. 

Challenges in treatment, care and support for TB–HIV co- infection cases

Linking positive clients to nodal ART centre is one of the greatest challenges faced in our district, because of two main reasons; distance between ICTC centre Phek and nodal ART centre is 145 kms away wherein estimation of expenses incurred for one visit to nodal ART centre by a client comes to Rs.4000 and almost all our clients coming from poor economic background cannot afford the cost.

During one of our HIV-TB meetings, we came to a consensus that in case of such HIV-TB co-infection cases; we will directly link up to ART as we came to learn that they are eligible for ART even before getting their CD4 count being tested.