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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 2016

In the year 2016, 63,753 (97%) of all TB cases notified had their HIV test results recorded at time of notification, which was slightly higher than that of 2015 data which stood lower at 93%. Among those who tested for HIV , 21,720 (34%) cases were found to be co- infected with HIV. The co infection has slightly decreased compared to 2015 whereby the co infected cases were at 36%. Furthermore, analysis shows that among co-infected cases 20,709 (95%) cases were registered at HIV care and Treatment clinics (CTCs) for care and treatment services.

Furthermore 20,895 (96%) were put on Co-trimoxazole Preventive Therapy (CPT) while 19,814 (91%) were initiated ART in at both TB clinic and CTCs. Figure 5 below summarizes the trend of TB/HIV indicators in the country from 2007 to 2016 with significant gains in the proportion of those initiated ART especially after the year 2011.

Trend of TB patients counselling and testing for HIV, initiated CPT and ART: 2007 – 2016

Regional performance on HIV testing and counselling and ART uptake

HIV counselling is entry point for accessing HIV care, treatment and preventive services. In 2016 the national average was 97% which is still below the WHO target of 100%. The majority of the regions are above the national average and Unguja in addition to few regions are below the average which included: Dar Kinondoni, Dodoma, Geita, Kigoma, Lindi, Mara, Mbeya, Morogoro, Njombe, Dar Ilala II, Kilimanjaro, Mwanza, Simiyu and Rukwa.

HIV testing among TB patients in 2016 by regions