The latest issue of Public Health Action includes a retrospective cohort study of 2013 records from a primary healthcare clinic in Zimbabwe, which showed that, of patients who were diagnosed with both HIV and TB, 90 percent were initiated on antiretroviral treatment (ART) and 88 percent began receiving cotrimoxazole preventive therapy (CPT). However, of HIV-positive patients who did not have TB, only 38 per cent were started on ART and 40 per cent on CPT.
The study compared referral to and provision of HIV care among presumptive tuberculosis patients, including those who proved to have TB and those who did not, in a primary healthcare clinic in Bulawayo, Zimbabwe. It was conducted by researchers from The Union, the Health Services Department of the City of Bulawayo and the Ministry of Health and Child Care.
Other findings indicated:
- one of five patients knew their HIV-positive status when they came to the clinic
- three quarters of those who consented to have an HIV test were HIV-infected
- of these newly diagnosed HIV-positive patients, 26 per cent also had tuberculosis
- three per cent of the patient records did not include a TB diagnosis.
As a result, the research team recommended strengthening service linkages so that ART and CPT reaches all patients who need these life-saving interventions. A ‘test and treat’ approach could also be considered for patients diagnosed with HIV through a TB entry point, such as a primary healthcare clinic. This could be especially effective in southern Africa with its high burdens of HIV infection and tuberculosis.
This study was undertaken with support from the Structured Operational Research and Training IniTiative (SORT-IT).
Read the whole study: Are HIV-positive presumptive tuberculosis patients without tuberculosis receiving the care they need in Zimbabwe?
Photo: Constance Manwa and her son. Constance is living with HIV and recovered from MDR-TB.