TY - JOUR
T1 - Provider-Initiated HIV testing and counseling among patients with presumptive tuberculosis in Democratic Republic of Congo
AU - Yotebieng, Marcel
AU - Wenzi, Landry Kipula
AU - Basaki, Emmanuel
AU - Batumbula, Marie Louise
AU - Tabala, Martine
AU - Mungoyo, Eugenie
AU - Mangala, Richard
AU - Behets, Frieda
N1 - Funding Information:
Implementation of TB and HIV program in Kinshasa and Kisangani was conducted in collaboration with the Kinshasa School of Public Health, the National AIDS Control Program (PNLS), the National TB Program (PNLT), the Provincial Coordination of PNLS and PNLT, and was funded by the President’s Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention [grant number 5U2GPS001179-01]. MY is partially supported by a grant from NICHD: R01HD075171 and a grant from NIAID: U01AI096299.
Funding Information:
The DRC is a high TB and HIV burden country. Access to HIV testing remains extremely low. According to the recent national Demographic Health Survey, 68% of men and 63% of women have never been tested for HIV or do not know their HIV status [10]. In 2013, HIV status was known for only 44% of notified TB cases from DRC of whom 14% were HIV positive [3]. In 2010, the Schools of Public Health of the University of North Carolina at Chapel Hill (UNC) and of the University of Kinshasa (KSPH) with funding from the President´s Emergency Plan For AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC), and in collaboration with the DRC’s National TB Program (PNLT) and the National AIDS Control Program (PNLS) started providing operational and logistical support to TB clinics in Kinshasa and in Kisangani, the capital of the Oriental Province (one of the provinces with the highest HIV prevalence). The objective of this collaboration was to support implementation of TB/HIV collaborative activities including routine implementation of PITC for all patients seeking care in the clinics with symptoms suggestive of TB. Before the UNC/KSPH program, routine HIV counseling and testing was only offered to patients with confirmed TB and the uptake was quite high [11, 12]. As part of the UNC/KSPH program, in each supported clinic, personnel involved in out-patient consultations were trained on TB symptoms screening, all patients with cough lasting more than two weeks or any other symptom suggestive of TB were routinely offered HIV testing and counseling. According to national guidelines, all patients diagnosed with HIV were offered cotrimoxazole prophylaxis onsite. HIV/TB patients were referred to HIV clinics for antiretroviral therapy (ART) after at least two weeks and within eight weeks of anti-TB treatment. HIV-infected patients with negative TB diagnosis were referred immediately to HIV clinics. TB diagnosis was based on the national algorithm (Programme Antituberculeux Integré IV) with at least one smear positive sample (for HIV-infected patients) and two positive samples for HIV-negative patients.
Publisher Copyright:
© Marcel Yotebieng et al.
PY - 2016
Y1 - 2016
N2 - Introduction: Provider-initiated HIV testing and counseling (PITC) of patients with presumptive tuberculosis (TB) is not widely implemented and the burden of HIV among them is not well characterized. We assessed the uptake of PITC and prevalence of HIV among patients with presumptive TB in primary care settings in the Democratic Republic of Congo. Methods: PITC was implemented in primary care TB clinics in Kinshasa and Kisangani, respectively. In each of the clinics, all patients presenting with cough lasting more than two weeks or any other symptom suggestive of TB were offered HIV testing and counseling and those found to be HIV+ were linked to HIV care and treatment. Results: Between November 2011 and June 2013, 43,145 patients with presumptive TB were registered in 65 clinics in Kinshasa of whom 84.0% were counseled; 92.4% of those counseled were tested and 4,320 (12.9%) were found to be HIV+. Similarly, in Kisangani, of the 6,687 patients with presumptive TB were registered in 13 clinics, 80.5% were counseled; 99.3% were tested for HIV and 619 (11.6%) were found to be HIV+. Conclusion: Implementation of PITC among patients with presumptive TB in primary care clinics was associated with high uptake of HIV testing and identification of high number of HIV+ patients.
AB - Introduction: Provider-initiated HIV testing and counseling (PITC) of patients with presumptive tuberculosis (TB) is not widely implemented and the burden of HIV among them is not well characterized. We assessed the uptake of PITC and prevalence of HIV among patients with presumptive TB in primary care settings in the Democratic Republic of Congo. Methods: PITC was implemented in primary care TB clinics in Kinshasa and Kisangani, respectively. In each of the clinics, all patients presenting with cough lasting more than two weeks or any other symptom suggestive of TB were offered HIV testing and counseling and those found to be HIV+ were linked to HIV care and treatment. Results: Between November 2011 and June 2013, 43,145 patients with presumptive TB were registered in 65 clinics in Kinshasa of whom 84.0% were counseled; 92.4% of those counseled were tested and 4,320 (12.9%) were found to be HIV+. Similarly, in Kisangani, of the 6,687 patients with presumptive TB were registered in 13 clinics, 80.5% were counseled; 99.3% were tested for HIV and 619 (11.6%) were found to be HIV+. Conclusion: Implementation of PITC among patients with presumptive TB in primary care clinics was associated with high uptake of HIV testing and identification of high number of HIV+ patients.
KW - DR Congo
KW - HIV prevalence
KW - PITC
KW - Presumptive tuberculosis
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U2 - 10.11604/PAMJ.2016.25.161.8125
DO - 10.11604/PAMJ.2016.25.161.8125
M3 - Article
C2 - 28292123
AN - SCOPUS:85016412150
SN - 1937-8688
VL - 25
JO - Pan African Medical Journal
JF - Pan African Medical Journal
M1 - 161
ER -
