Active Steps Employed Towards Meeting HIV Epidemic Control TB Activities Should Not be Neglected in HIV Services
TB Activities Should Not be Neglected in HIV Services
The Manager of the HIV Free SW Project, Dr. Atembeh Bernard says, “If we focus on HIV activities and neglect TB activities, we will never reach epidemic control”. The Manager made this statement during a two-day capacity building workshop for health care providers on the implementation of Isoniazid Preventive Therapy (IPT) in the SW region. He elucidated his point by noting that there is a high degree of co-infection of HIV/TB which the prevalence in Cameroon stands at 25% to 36%.
The capacity building workshop took place at the ACP Hall at the CBC Health Services Complex in Mutengene with participants learning skills such as; the clinical signs and symptoms for screening TB, the eligibility criteria for IPT amongst others.
The training was organized in two sessions for two days each; facilities with TB Diagnostic Treatment Centers (DTC) and the non-diagnostic treatment Centers. It is hoped that with this training, TB screening will be intensified, uptake of IPT in PLHIV screened negative for TB will increase, all TB presumptive cases referred to the nearest DTC for diagnosis and possible management and consequently, the burden of TB in PLHIV will be reduced.
Key Populations Activities Gaining Grounds in SW Region
A practical guide for Key Populations (KP) activities for Q2 (second quarter) has been laidout at the end of a two-day training on KP friendly services. The two-day training on KP friendly services took place in Health Services Complex Mutengene at the National EID Reference Laboratory Conference hall from December 19-20, 2019. The training brought together some HIVF staff who were index testers and testing counselors from four PEPFAR supported sites (RHL, BHM, RHB and District Hospital Kumba) in the SW region. The objective of the training was to empower participants with more knowledge so that they could be able to boost up KP activities in our facilities and thus create an impact in the region.
Given that the KP activities were low key in the greater part of the Q1, the Technical Director guided the staff in developing the action plan. Embedded in the action plan is mapping of KP hotspots, selection of KP champions, training of KP champions and carrying out various activities in the hotspots identified. The package of services to provide, what to do when you get to a KP area, how to identify KPs that are currently on treatment, and how to organize the facilities to be KP friendly were discussed.
Being the second of KP friendly activities training, the participants were advised to work closely with service providers in their sites that have been trained.
Relatedly, Moonlight testing activities and identification of some KP hotspots were embarked on in some health districts in the SW region. Headed by the KP Lead for Zone 1, identification of KP hot spots and Moonlight testing activities were done in Limbe, Buea, and Mutengene.
Health Care Providers Orientated on Screening Tool
Some 60 Health care providers have been orientated on the screening tool for effective identification of persons eligible for HIV testing at all entry points. This is to optimize HIV case identification and limit the wastage of already scarce HIV test kits in Health facilities. Meeting at the CBC Health Services complex in Mutengene recently, the orientation meeting brought together doctors, nurses, testing counselors and psychosocial counsellors drawn from the 24 PEPFAR supported sites in the SW region.
The main facilitator, Dr. Atanga Pascal schooled the health care providers on the screening tool for children <10 years, screening tool for adolescents and Adults >10 years. These files and the risk assessment form for children and adult/adolescents’ forms that have been printed were sent to the facility for effective implementation.
An important aspect handled was the pediatric and adolescent ARV Regiment. The required and alternative regimen for various ages and their weight was elaborated on. He noted that the Nevirapine regimen is no more recommended for children due to its high resistance rate amongst other issues.
Dr. Atanga urged all to go back and use the screening tool with the instructions followed as in the guideline. The HIVF Manager, Dr. Atembeh cautioned the staff to collaborate with the RTG-HIV and the HIV-Free SW project for the strict implementation of this very important activity that would move the country to attain the 1st 90.
Transitioning of Patient files to Improve Service Quality
According to the project standard and SIMS requirement, all the tools in the facility should be the national tools. It is from this backdrop that the Regional Hospital Buea (RHB) UPEC staff have been transitioning patients’ files. Before the start of Direct Service Delivery (DSD) in the facility, RHB was using facility printed patients’ tools, but to conform with the standards, the team lead sourced for patients’ files at the RTG to transition patient files.
The site lead noted that transitioning into the new files will be a step towards improving the quality of services to patient care. The new file prompts the service provider to ensure that certain services are offered to the clients and documented. For example, nutritional assessment, adherence to ARV, clinical and biological follow up which if strictly followed, will improve on the service quality to the client a major priority of the HIVF SW project.
A few challenges were encountered in the process. With a target to transition 1500 of a clientele of 2000, the first consignment RTG could supply was just 400. With others from the facility and some printed by the project later on, about 80% of the files have been transitioned. The transitioning of the files involved all staff of the UPEC working extra hours after work. This was so that patients’ flow and attention will not be disturbed. The facility hopes to continue with the transitioning as a routine activity and as the patients come for a refill.