Activists have given government three months to develop a practical plan to integrate TB and HIV treatment.
‘President Jacob Zuma announced new treatment guidelines last December. This included that TB and HIV care was supposed to happen under one roof,’ said Lihle Dlamini, deputy secretary general of the Treatment Action Campaign (TAC).
‘But patients with HIV and TB still have to go to different clinics or healthworkers for treatment,’ she told a briefing at the national TB conference in Durban.
‘We call on the Department of Health to draw up integration plans with three months and to start implementation without delay,’ added Dlamini.
Around 70 percent of South Africans with TB are also co-infected with HIV, and TB is the country’s biggest killer.
Health Minister Dr Aaron Motsoaledi said the proposal to integrate the two services had been accepted by government and the SA National AIDS Council (SANAC).
‘It’s not a matter of debate but a matter of implementation,’ Motsoaledi told the conference. ‘There are some technical problems, but we regard TB and HIV as two sides of the same coin.’
‘We want a patient coinfected with HIV and TB to be treated by one healthworker and to have one folder,’ said Lesley Odendal from Medicins sans Frontieres (MSF).
She said this integration had happened at the 11 clinics in Khayelitsha and this had greatly improved efficiency and clinical care. Previously, only one in five TB patients were referred for antiretroviral treatment, whereas in some clinics around 68 percent of people with TB were also on ARV treatment.
Dr Krista Dong from iTeach at Edendale Hospital said many HIV positive patients with TB were not diagnosed or treatment was delayed, partly because it took a long time for their sputum (spit) tests to be processed.
‘Healthworkers can make a clinical diagnosis of TB based on asking patients a few basic questions: Is the patient HIV positive? Do they have signs and symptoms of TB, such as night sweats or fever? Have they been exposed to someone with TB?’ said Dong.
‘It’s really not rocket science. A lay person can be trained to do it following a simple algorithm [set of tules].’
Dr Francois Venter, head of the SA HIV Clinicians Society, said the delay in integrating services was being done at the expense of patients: ‘If all TB nurses could initiate patients on ARVs in the TB clinics, this would save a huge number of lives in a short time.’ ‘ Health-e News Service.
