Scale-up of TB and HIV programme collaborative activities in Zambia - a 10-year review

Trop Med Int Health. 2012 Jun;17(6):760-6. doi: 10.1111/j.1365-3156.2012.02981.x. Epub 2012 Apr 5.

Abstract

Objective: To review the activities, progress, achievements and challenges of the Zambia Ministry of Health tuberculosis (TB)/HIV collaborative activities over the past decade.

Methods: Analysis of Zambia Ministry of Health National TB and HIV programme documents and external independent programme review reports pertaining to 2000-2010.

Results: The number of people testing for HIV increased from 37 557 persons in 2003 to 1 327 995 persons in 2010 nationally. Those receiving anti-retroviral therapy (ART) increased from 143 in 2003 to 344 304 in 2010. The national HIV prevalence estimates declined from 14.3% in 2001 to 13.5% in 2009. The proportion of TB patients being tested for HIV increased from 22.6% in 2006 to 84% in 2010 and approximately 70% were HIV positive. The proportion of the HIV-infected TB patients who: (i) started on ART increased from 38% in 2006 to 50% in 2010; (ii) commenced co-trimoxazole preventive therapy (CPT) increased from 31% in 2006 to 70% in 2010; and (iii) were successfully treated increased to an average of 80% resulting in decline of deaths from 13% in 2006 to 9% in 2010.

Conclusions: The scale-up of TB/HIV collaborative programme activities in Zambia has steadily increased over the past decade resulting in increased testing for TB and HIV, and anti-retroviral (ARV) rollout with improved treatment outcomes among TB patients co-infected with HIV. Getting service delivery points to adhere to WHO guidelines for collaborative TB/HIV activities remains problematic, especially those meant to reduce the burden of TB in people living with HIV/AIDS (PLWHA).

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / methods
  • Antitubercular Agents / therapeutic use
  • Cooperative Behavior
  • Female
  • Follow-Up Studies
  • Government Programs / organization & administration*
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control*
  • Health Promotion / organization & administration*
  • Humans
  • Male
  • Middle Aged
  • Pregnancy
  • Prevalence
  • Program Evaluation
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Tuberculosis / epidemiology*
  • Tuberculosis / prevention & control*
  • Young Adult
  • Zambia / epidemiology

Substances

  • Anti-HIV Agents
  • Anti-Infective Agents
  • Antitubercular Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination