OBJECTIVES: To describe the development and operation of integrated tuberculosis (TB) and HIV care at the Martin Preuss Centre, a multipartner organization bringing together governmental and non-governmental providers of HIV and TB services in Lilongwe, Malawi. METHODS: We used a case study approach to describe the integrated TB/HIV service and to illustrate successes and challenges faced by service providers. We quantified effective TB and HIV integration using indicators defined by the World Health Organization. RESULTS: The custom-designed building facilitates patient flow and infection control, and other important elements include coordinated leadership; joint staff training and meetings; and data systems prompting coordinated care. Some integrated services have worked well from the outset, such as promoting HIV testing among patients with TB (96% of patients with TB had documented HIV status in 2009). Other aspects of integrated care have been more challenging, for example achieving high uptake of antiretroviral therapy among HIV-positive TB patients and combining data from paper and electronic systems. Good TB treatment outcomes (>85% cure or completion) have been achieved among both HIV-positive and HIV-negative individuals. CONCLUSIONS: High-quality integrated services for TB and HIV care can be provided in a resource-limited setting. Lessons learned may be valuable for service providers in other settings of high HIV and TB prevalence.
OBJECTIVES: To describe the development and operation of integrated tuberculosis (TB) and HIV care at the Martin Preuss Centre, a multipartner organization bringing together governmental and non-governmental providers of HIV and TB services in Lilongwe, Malawi. METHODS: We used a case study approach to describe the integrated TB/HIV service and to illustrate successes and challenges faced by service providers. We quantified effective TB and HIV integration using indicators defined by the World Health Organization. RESULTS: The custom-designed building facilitates patient flow and infection control, and other important elements include coordinated leadership; joint staff training and meetings; and data systems prompting coordinated care. Some integrated services have worked well from the outset, such as promoting HIV testing among patients with TB (96% of patients with TB had documented HIV status in 2009). Other aspects of integrated care have been more challenging, for example achieving high uptake of antiretroviral therapy among HIV-positive TB patients and combining data from paper and electronic systems. Good TB treatment outcomes (>85% cure or completion) have been achieved among both HIV-positive and HIV-negative individuals. CONCLUSIONS: High-quality integrated services for TB and HIV care can be provided in a resource-limited setting. Lessons learned may be valuable for service providers in other settings of high HIV and TB prevalence.
Authors: C Feldacker; H Tweya; O Keiser; R Weigel; M Kalulu; L Fenner; M Egger; E Manda; J B Mwafilaso; C Kamba; S Phiri Journal: Trop Med Int Health Date: 2012-07-19 Impact factor: 2.622
Authors: Sabine M Hermans; Barbara Castelnuovo; Catherine Katabira; Peter Mbidde; Joep M A Lange; Andy I M Hoepelman; Alex Coutinho; Yukari C Manabe Journal: J Acquir Immune Defic Syndr Date: 2012-06-01 Impact factor: 3.731
Authors: M Loveday; K Wallengren; A Voce; B Margot; T Reddy; I Master; J Brust; K Chaiyachati; N Padayatchi Journal: Int J Tuberc Lung Dis Date: 2012-02 Impact factor: 2.373
Authors: Kimcheng Choun; Reaksmey Pe; Sopheak Thai; Natalie Lorent; Lutgarde Lynen; Johan van Griensven Journal: Bull World Health Organ Date: 2012-12-12 Impact factor: 9.408
Authors: Joel C Chehab; Amanda K Vilakazi-Nhlapo; Peter Vranken; Annatjie Peters; Jeffrey D Klausner Journal: PLoS One Date: 2013-03-04 Impact factor: 3.240