COLLABORATIVE TB/HIV ACTIVITIES
TB and HIV are overlapping epidemics, both have been declared global emergencies demanding global attention. There is an increasing recognition of the need to strengthen collaboration between national TB and HIV/AIDS programmes and other stakeholders in countries around the world because of the overlapping nature of TB and HIV infection. In particular, there is evidence that HIV infection weakens the immune system, thereby fueling the TB epidemic among people living with HIV/AIDS (PLHA).
On the other hand, TB is the main opportunistic infection and leading cause of deaths among PLHA. In many countries, TB cases have been increasing in tandem with rising HIV prevalence. In sub-Saharan Africa, for instance, a fourfold rise in TB cases related to the HIV epidemic has been reported. The situation in Tanzania is not different from that in many sub-Saharan countries.
A review of the implementation of collaborative TB/HIV activities that took place in 2005 showed that TB/HIV activities had been established, but there was no national policy framework to guide the implementation process. At the global level, the World Health Organisation (WHO) formulated an interim policy in 2004 to guide member states in implementing collaborative TB/HIV activities.
Tanzania Ministry of health developed National Policy Guidelines for Collaborative TB/HIV activities with the overall objective to provide a framework for ensuring transparent and consistent processes in developing comprehensive collaborative TB/HIV activities. This objective emphasizes the need for joint decision-making processes that take into account the comparative advantages of the NTLP, NACP, and other stakeholders.
TB/HIV CASE FINDING 2018
In the year 2018, 73,669 (99%) of new and relapse cases notified had their HIV test results recorded at time of notification. Among the tested, 20,714 (28%) were tested HIV positive. The co infection rate has decreased from 31% in years 2017. Furthermore, analysis shows that among co-infected cases 20,371 (98%) cases were initiated or were on ART at both TB clinic and CTCs and 19,226 (93%) were put on Co-trimoxazole Preventive Therapy (CPT). Figure 5 below summarizes the trend of TB/HIV indicators in the country for the last five years: 2014 to 2018. In the figure, it shows that uptake of ART as increased from 83% in 2014 to 98% in 2018.
Regional performance on HIV testing and counselling and ART uptake
HIV counselling and testing is entry point for accessing HIV care, treatment and preventive services. In 2018 the national average was 99% which is still below the WHO target of 100%. The majority of the regions are above the national average, with 12 out of 28 regions being below.
Figure 1: HIV testing among TB patients in 2018 by regions