Efficacy of a new model for delivering integrated TB and HIV services for people living with HIV/AIDS in Delhi -- case for a paradigm shift in national HIV/TB cross-referral strategy
| Autor: | Girraj Pratap Singh, Sudha Goel, Anil Kumar Gupta, Bipin Chandra Joshi, Pratap Bhan Kaushik, Sabyasachi Chakraborty |
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| Rok vydání: | 2013 |
| Předmět: |
Program evaluation
Adult Counseling Male Pediatrics medicine.medical_specialty Health Knowledge Attitudes Practice Health (social science) Tuberculosis Social Psychology Referral Adolescent Anti-HIV Agents Voluntary counseling and testing Human immunodeficiency virus (HIV) Antitubercular Agents India HIV Infections Pilot Projects medicine.disease_cause Acquired immunodeficiency syndrome (AIDS) medicine Humans Hiv services Community Health Services Lost to follow-up Child Referral and Consultation Aged Aged 80 and over business.industry Coinfection Health Policy Public Health Environmental and Occupational Health Middle Aged medicine.disease Government Programs Child Preschool Female business Program Evaluation |
| Zdroj: | AIDS care. 26(2) |
| ISSN: | 1360-0451 |
| Popis: | Under National TB/HIV framework, all TB patients are referred by Revised National Tuberculosis Programme (RNTCP) service providers to Integrated Counseling and Testing Centers (ICTCs) for voluntary counseling and testing (CT) and ICTC "TB-suspects" are referred to RNTCP facilities for TB diagnosis and treatment. HIV-TB coinfected patients are then referred to Anti Retroviral Treatment (ART) center for initiation of ART between two weeks and two months of initiating TB treatment. During the third phase of National AIDS Control Programme (NACP-III, April 2007-April 2012), 30749/130503 (23.6%) TB/HIV cross-referrals were lost to follow up (LTFU) and there was missed opportunity for 940/1884 (49.9%) HIV-TB coinfected patients for initiation of ART during TB treatment. This motivated Delhi State AIDS Control Society (DSACS) and State TB Cell (STC) to revise existing cross-referral strategy. The new strategy was launched in May 2012, wherein HIV-TB coinfected and HIV-positive "TB-suspects" were referred to nearest ART center for HIV care and investigations of TB at Chest Clinic/Designated Microscopy Centre (DMC) located within the same hospital instead of referral to area RNTCP facility. Outcome of the strategy was evaluated in March 2013. The new HIV-TB cross-referral strategy in Delhi has shown advantage over national strategy: first, improved retention of coinfected clients in HIV care; second, ensured timely initiation of TB-treatment and ART; and third, significantly improved survival of HIV-TB coinfected patients. |
| Databáze: | OpenAIRE |
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