DAPCU Vizianagaram Response to DCC for HIV-TB

1.          Advantages of DCC in HIV-TB collaboration activity

        

                     The coordination between two programmes is very essential in HIV/AIDS Control Programme that is National AIDS Control Programme & Revised National TB Control Programme.  The both deceases are going together to increase mortality in People Living with HIV/AIDS.  Until or unless diagnosis of TB and treating TB among HIV patients we can’t improve quality of life and reduce deaths.  Simultaneously the RNTCP also should make all TB patients test for HIV and send them for ART

District Coordination Committee chaired by District Collector and meets once in quarter to discuss the progress of the HIV-TB collaboration activities in the district and identifying gaps, issues and requirements for further improvement.  The members are ADM & HO (A&L), DTCO, DCHS, MOTC, MO- TU, MO-ART, MO/Counsellor – ICTC, MO-CCC, DPM, DIS and representative from ICDS.

·         Improves quality in service delivery both NACP & RNTCP

·         Coordination between both programmes will be improved

·         Address gaps and get the support from DC or Dept. Heads

2.      DCC for TB – HIV strengthen the cross referrals between the ICTC and RNTCP (diagnostic and treatment services, and ART and DOTS services, and overall implementation of the National framework for TB – HIV Collaborative activities).

DAPCU conducts DCC meeting every quarter as per the instructions of APSACS and sharing minutes with all for implementing the recommendations given by the committee.

·         All PHCs integrated with FICTC activities and RNTCP activities

·         All 36 DMCs were covered with HIV testing facility.

·         All DMC LTs were trained on HIV screening.

·         All TB suspects are also being tested for HIV in the District.

·         Line listing and pairing every month for finding missed TB cases for HIV testing through ICTC counsellors Outreach work and MICTC (Mobile ICTC).

·         DOT Plus Supervisor & DIS are jointly visiting ART Centre and ICTC for supportive supervision.

·         All Known HIV infected TB patients should be initiated on CPT and ART at time of registration.

·         Each and every person attending the ICTC with cough of two weeks duration and with cough of one day duration in HIV positive clients are referred to the Designated Microscopy Centre for sputum test.

·         All TB and HIV Positive Cases are getting ART with irrespective of CD4 count as per new guidelines.

·         We are involving with RNTCP staff in monthly review meetings under control of DM & HO to improve coordination between RNTCP and HIV/AIDS Programme

                                           Total TB cases in the District      : 3686

                                           Test for HIV                               : 3439

                                           %                                             : 93%

                                           HIV/TB Co- Infected cases          : 253

                                           in the district 

                                           HIV/TB Co- Infected cases          : 208

                                           put on ART 

                                           %                                              : 82%

3.  Appropriate measures are taken to prevent the spread of TB infection in facilities caring for HIV – AIDS and spread of HIV infection through safe injection practices in the facilities providing RNTCP treatment services.

            APSACS has supplied IEC material like posters and pamphlets on TB to DAPCU.  The messages on TB Prevention are spreading through IEC material at all facilities in the district.  DAPCU covers one topic on TB in every training, sensitization and review meetings and ASHAs, ANMs, AWWs, and Field level staff is being oriented regularly by NACP and RNTCP programmes. Universal precaution guidelines are always being adhered to for ensuring non transmission through the processes of health care provision at any of the service delivery units of HIV, TB and its CST.

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

·         The testing of TB for all HIV cases before treating with ART is mandatory and strictly followed by ART centre.

·         Each and every person attending the ICTC with cough of two weeks duration and with cough of one day duration in HIV positive clients are referred to the Designated Microscopy Centre for sputum test.

Year	2011-2012(Dec)	2010-2011	2009-2010
ICTC to RNTCP referral	2548	4948	4216
RNTCP to ICTC referral	1429	1955	2321

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

·         Team of NACP & RNTCP have been sensitized and oriented many times on importance of treating HIV-TB co infected cases and giving priority in providing services at ART.

·         Involving NGOs, RNTCP and General Health cadres in tracking of untreated HIV-TB co infected cases by sharing line list every month.

·         Encouraging DOT Plus supervisor to visit ART centre to identify the gaps and involving RNTCP staff for field level support.

·         Involving DTCO in ART Centre coordination meetings, Monthly review meetings.