DAPCU Nalgonda Response to DCC for HIV-TB

The overall objective of the DCC District Coordination Committee for TB/HIV is to ensure the implementation of TB/HIV collaboration activities in the District and review the performance of the same.

In this context Nalgonda DAPCU has been conducted the DCC meeting on 26^th of October 2012 under the chairmanship of District Collector. During this meeting all the line department staff of DM&HO, DTCO, Addl. DM&HO, DCHS, DPM NRHM, ART SMO, and President DLN invited for sharing their views and sort out the complications came while working.

The main agenda of the HIV/TB DCC meeting is

Ø  Performance review ICTC/DMC level

Ø  Line List preparation

Ø  ICTC to RNTCP referrals review Vice-versa

Ø  Discussion on HIV/TB co infected cases pre ART registration

Ø  Discussion on coordination between ICTC to RNTCP

Ø  Sharing of experiences

TB is the most common opportunistic infection in people living with HIV. As HIV breaks down the immune system, HIV- infected people are at greatly increased risk of TB. TB in turn accelerates the progression of HIV to AIDS and shortens the survival of patients with HIV infection. Thus, TB and HIV are closely interlinked

In order to provide HIV testing facilities for individuals diagnosed with TB as well as to understand the TB status of HIV positive individuals it is important promote coordination and information sharing between DMCs and ICTCs. The in referrals from RNTCP to ICTC over the past

It was observed that, there is a gap between cross referral of RNTCP to ICTC vice versa. Hence we noticed these many issues in the DCC meeting, and the DAPCU is planning to take up special drive on HIV/TB intensified case finding in the coming months.

S.no	HIV-TB
	Key Indicators	2009-2010	2010-2011	2011-2012	Up to Dec 2012
1	Total Cross Referrals (ICTC <> RNTCP)	5687	5842	6076	5129
2	Clients referred from ICTC to RNTCP	3417	3894	3885	3074
3	Clients referred from RNTCP to ICTC	2270	1948	2191	1381
4	Co-Infection target	342	307	599	599
5	Co-Infection	307	193	153	106
6	%Achievement                        (HIV-TB Co-Infection)	89.76	62.86	26.9	18.0

Having a holistic campaign by DAPCU and DTO to address the issue of low cross referrals between the HIV and RNTCP facilities by increasing the outreach combined with the simple messages with the support of the line departments

Conducted training to DMC LTs on HIV testing preferably SD screening Test. During this 28 DMC LTs have been trained on whole blood testing & counseling.

DAPCU has taken the line-list of LFU/MIS patients from ART and segregate it geographically to each NGO. The review of this activity conducted in each month in ART/CCC coordination meeting

DAPCU raised a concern about the entry in HIV-TB ART TB treatment should enter correctly on white card.  After testing of TB patient, the HIV status should include in the TB register.

In Intensified TB care finding every facility should develop good rapport with each OPD. Maximum referrals from OPD (Acute respiratory tract infection) Cough with expectation referred for TB Screening.

The District Collector instructed to DM&HO, to address the issues related to HIV/TB co-infectious cases by visiting the field and interact with the patients. According to this, instructed to DTCO and DAPCU to plan it as early as possible. 

Discussed about the X-Ray machine, it is not functioning properly in DTCO Office, in this context the District Collector suggested to DCHS to pursue the issue and submit a report regarding this. Regarding X-Ray machine the DTCO told that, it is an old model machine and not showing the proper result, hence the cases are referring to the district hospital located in the same premises because there is an advanced technology X-Ray machine for accurate result