Use of demand-driven approaches to improve the determination of TB burden amongst people living with HIV [PLHIV] across 28 health facilities in Nigeria
Image credit: The 49th Union World Conference on Lung Health
Abstract
Nigeria is one of seven countries that contribute to 64% of the global burden of TB, ranking 6th ahead of S-Africa. Sub-Saharan Africa bears 70% of the global HIV burden; Nigeria ranks 2nd in the region and 3rd globally with a prevalence of 3.4%. Given that the burden of Tuberculosis among PLHIVs is 16-27% higher than in the general population, innovative means to increase TB case finding among this group is essential. CRS supports over 17,900 PLHIV’s with comprehensive HIV care and treatment services distributed among 28 secondary health facilities across 5 states. Inconsistency in routine TB screening and documentation by health providers necessitated innovative approaches to determine TB status among PLHIV. An individualized approach was adopted involving an audit of patient charts to determine which clients had documented TB screening. Using awareness creation, health education, counselling and advocacy to PLHIV support groups, client’s awareness and demand for TB screening during routine clinic visits was increased. Clients were also tracked through home visits, and/or phone calls and clinical TB screening was administered using the four cardinal questions. This approach led to a 23% increase in PLHIV screened for TB , with an associated 49% increase in the number of PLHIV who were initiated on Isoniazid Preventive Therapy. During the two-month period, 574 presumptive TB cases and 87 active cases were also identified.