AEGiS-15IAC: HIV testing and counselling and adjunctive cotrimoxazole for TB patients in Malawi: From research to implementation.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HIV testing and counselling and adjunctive cotrimoxazole for TB patients in Malawi: From research to implementation.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrD1205)

Chimzizi RB
TB Control Programme, Lilongwe, Malawi

BACKGROUND: Malawi, a small land-locked country in Southern Africa, has one of the highest prevalence rates of HIV infection in the world, with AIDS leading cause of death among 15-49 year olds. This year (2003) it is estimated that there are approximately 900,000 adults and children living with HIV AIDS out of a population of 11.5 million. Since the first AIDS case was reported in 1985, the Malawi National TB Control Programme has reported a five-fold increase of TB notification cases. In the year 2002 about 27000 TB cases were reported with an alarming 19% case fatality rates in new smear positive TB cases. Setting: 15 hospitals in Malawi offering voluntary counselling and testing (VCT) for TB patients and cotrimoxazole preventive therapy (CPT) for TB patients found to be HIV-positive. Objectives: (i) to describe the process of developing a national TB/HIV plan, conducting a country-wide situation assessment and producing a national guidelines on VCT and CPT for TB patients, and (ii) to assess the implementation of VCT and CPT for TB patients registered between July and September 2003.

RESULTS: The 3-year HIV/TB plan was finalised in 2002. Between January and March 2003, an assessment was carried out of HIV/AIDS and joint HIV-TB services in Malawi. Between April and June 2003, national guidelines on VCT and CPT were developed through a consultative process, and treatment units were prepared for the implementation. Between July and September 2003, 2397 patients were registered for anti-TB treatment, 1404 (59%) accepted VCT, 956 (68%) were HIV positive of whom 927 (97%) started on CPT. Some deficiencies in the registration process and patient understanding about VCT and CPT were identified. Conclusion The results show that it is feasible to routinely implement VCT and CPT for TB patients

Keywords: AEGIS, Trimethoprim-Sulfamethoxazole Combination, Counseling, Acquired Immunodeficiency Syndrome, Research, HIV Infections, HIV Seropositivity, Prevalence, Voluntary Programs, Malawi, Research Design, Africa, Southern, Adult, Child, Humans, prevention & control, therapy, organization & administration

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TuOrD1205