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VOLUME 58 , ISSUE 1 ( January-March, 2016 ) > List of Articles

Original Article

HIV-TB Cross-referral and Collaborative Strategy: 8 Years of Our Experience from An Urban Health Centre in North India

Bhanu Mehra, Monika Matlani, Deepti Rawat, Hitender Gautam, Preena Bhalla

Keywords : Human immunodeficiency virus (HIV), Tuberculosis (TB), Cross-referral, India, Integrated counselling and testing centre (ICTC)

Citation Information : Mehra B, Matlani M, Rawat D, Gautam H, Bhalla P. HIV-TB Cross-referral and Collaborative Strategy: 8 Years of Our Experience from An Urban Health Centre in North India. Indian J Chest Dis Allied Sci 2016; 58 (1):11-16.

DOI: 10.5005/ijcdas-58-1-11

License: CC BY-NC 4.0

Published Online: 17-11-2022

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics continue to fuel each other and with dual infections with these two deadly diseases on the rise, it becomes imperative to devise effective HIV-TB collaborative strategies. The present study was designed to evaluate the existing HIV-TB cross-referral mechanism at an urban health centre; to determine HIV sero-prevalence among pulmonary TB patients referred from chest clinic to the integrated counselling and testing centre (ICTC); and to evaluate the TB suspects referred from ICTC to the chest clinic for a possible TB aetiology. Methods: The present study was a retrospective analysis of HIV-TB cross-referrals whereby a line list of all the patients referred under this strategy from January 2006 to December 2013 was retrieved and analysed. Results: A total of 3726 TB cases were referred to the ICTC and 641 TB suspects were identified by ICTC counsellors and referred to the chest clinic during this period. HIV sero-prevalence among TB patients was 2.8% (106 of 3726) and TB prevalence among HIV sero-positive and sero-negative TB suspects was 9.3% (10/108) and 4.3% (9/211), respectively (p=0.07). HIV prevalence was found to be significantly higher among male (n=2024) than among female (n=1702) TB patients (4.4% versus 0.9%; p<0.0001). Only 319 of 641 (49.8%) ICTC patients referred to the chest clinic reached there. Conclusion: Our study highlights the strong need to scale up the integration and partnership between HIV and TB programmes for better and integrated diagnosis and care of HIV-TB co-infected patients.


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  1. Revised National TB Control Programme. TB India 2014. Annual Status Report. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi. Available at URL: http://www.tbcindia.nic.in/pdfs/TB%20INDIA%202014. pdf . Accessed on April 02, 2016.
  2. Department of AIDS Control. National AIDS Control Organization. Ministry of Health and Family Welfare, Government of India. Annual Report 2010-11. Available at URL: http://www.nacoonline.org/upload/REPORTS/ NACO%20Annual%20Report%202010-11.pdf. Accessed on April 02, 2016.
  3. Yusuph H, Zailani SB, Ahidjo A. Prevalence of HIV infection in tuberculosis patients in Nguru, Northeastern Nigeria. Sahel Med J 2005;8:65–7.
  4. van Altena R, van der Werf TS. Underdiagnosis of HIV in patients with tuberculosis. Ned Tijdschr Geneeskd 2007;151:2652–4.
  5. Training Module for Medical Officers on TB/HIV, 2005. Central TB Division and National AIDS Control Organization, New Delhi. Available at URL: http// www.naco.gov.in/upload/Publication/Basic Services/ Training Modules on HIV-TB Training/Training Module for Medical Officers on TB-HIV/Training module for medical officers on TBHIV.pdf. Accessed on April 02, 2016.
  6. Seth P. The situation of HIV/M. tuberculosis co-infection in India. Open Infect Dis J 2011;5:51–9.
  7. Vaidyanathan P. An introduction to TB-HIV collaborative activities in India. NTI Bull 2008;44:3-4.
  8. Panjabi R, Comstock GW, Golub JE. Recurrent tuberculosis and its risk factors: adequately treated patients are still at high risk. Int J Tuberc Lung Dis 2007;11:828–37.
  9. Campos PE, Suarez PG, Sanchez J, Zavala D, Arevalo J, Ticona E, et al. Multidrug-resistant Mycobacterium tuberculosis in HIV-infected persons, Peru. Emerg Infect Dis 2003;9:1571–8.
  10. Del Amo J, Malin AS, Pozniak A, De Cock KM. Does tuberculosis accelerate the progression of HIV disease? Evidence from basic science and epidemiology. AIDS 1999;13:1151–8.
  11. Saraceni V, King BS, Cavalcante SC, Golub JE, Lauria LM, Moulton LH, et al. Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil. Int J Tuberc Lung Dis 2008;12:769–72.
  12. Raizada N, Chauhan LS, Babu BS, Thakur R, Khera A, Wares DF, et al. Linking HIV-infected TB patients to cotrimoxazole prophylaxis and antiretroviral treatment in India. PLoS One 2009;4:e5999.
  13. Sharma A, Wanchu A, Bansal V, Singh S, Varma S. Improvement in CD4 counts in HIV positive patients treated with HAART and antitubercular drugs: an observational study from North India. Indian J Pathol Microbiol 2007;50:905–7.
  14. National Framework For Joint HIV/TB Collaborative Activities, October 2009. National AIDS Control Organization and Central TB Division, Ministry of Health and Family Welfare, Government of India, New Delhi. Available at URL: http:// www.tbcindia.nic.in/pdfs/Final National Framework for TB HIV Collaboration 2009.pdf . Accessed on April 02, 2016.
  15. National AIDS Control Organisation, Ministry of Health and Family Welfare. Guidelines for HIV testing 2007. Available at URL: http://naco.gov.in/upload/Policies% 20&%20Guidelines/5-GUILDELINES% 20FOR%20HIV% 20TESTING.pdf. Accessed on April 02, 2016.
  16. Revised National TB Control Programme. TB India 2013. Annual Status Report. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi. Available at URL: http://www.tbcindia.nic.in/pdfs/TB%20India% 202013.pdf. Accessed on April 02, 2016.
  17. Revised National TB Control Programme. Training Module for Community Pharmacists 2013. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi. Available at URL: http://www.pci.nic.in/Circulars/Training% 20Module.pdf. Accessed on April 02, 2016.
  18. Sharma SK, Saha PK, Dixit Y, Siddaramaiah NH, Seth P, Pande JN. HIV seropositivity among adult tuberculosis patients in Delhi. Indian J Chest Dis Allied Sci 2000;42:157–60.
  19. Piramanayagam P, Tahir M, Sharma SK, Smith-rohrberg D, Biswas A, Vajpayee M. Persistently high HIV seroprevalence among adult tuberculosis patients at a tertiary care centre in Delhi. Indian J Med Res 2007;125:163–7.
  20. Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglione MC et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 2003;163:1009–21.
  21. Pandey A, Sahu D, Bakkali T, Reddy D, Venkatesh S, Kant S, et al. Estimate of HIV prevalence and number of people living with HIV in India 2008-2009. BMJ Open 2012;2:e000926.
  22. Raizada N, Chauhan LS, Khera A, Sokhey J, Wares DF, Sahu S, et al. HIV seroprevalence among tuberculosis patients in India, 2006-2007. PLoS One 2008;3:e2970.
  23. Sawant SS, Agrawal SR, Shastri JS, Pawaskar M, Kadam P. Human immunodeficiency virus infection among tuberculosis patients in mumbai. J Lab Physicians 2011;3:12–4.
  24. Ramachandran R, Chandrasekaran V, Muniyandi M, Jaggarajamma K, Bagchi A, Sahu S. Cross-referral between HIV counselling and testing centres and smear microscopy centres in Tamil Nadu. Int J Tuberc Lung Dis 2009;13:221–5.
  25. Grant AD, Djomand G, De Cock KM. Natural history and spectrum of disease in adults with HIV/AIDS in Africa. AIDS 1997;11(Suppl. B):S43–54.
  26. Ansari NA, Kombe AH, Kenyon TA, Hone NM, Tappero JW, Nyirenda ST et al. Pathology and causes of death in a group of 128 predominantly HIV-positive patients in Botswana, 1997–1998. Int J Tuberc Lung Dis 2002;6:55–63.
  27. Devi SB, Naorem S, Singh TJ, Singh KB, Prasad L, Devi TS. HIV and TB Co-infection: a study from RIMS Hospital, Manipur. J Indian Acad Clin Med 2005;6:220–3.
  28. Shrivastava SR, Shrivastava PS. HIV-tuberculosis interface: a comparison of collateral prevalence of HIV and tuberculosis in an urban health centre. Ann Trop Med Public Health 2013;6:290–6.
  29. Scaling up TB/HIV in India: what is achieved and what is remaining? 19th Core Group meeting of the Global TB/HIV Working Group. Available at URL: www.who.int/entity/tb/challenges/hiv/scaling_up_tbhiv_ in_india_-_what_is_achieved_and_what_is_remaining.pdf. Accessed on April 02, 2016.
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