Swaziland is classified by WHO as a high burden HIV country – 73% of TB patients were HIV positive in 2014. While uptake of CPT among TB/HIV co-infected patients was high (98%), only 79% of HIV-positive TB patients were on ART.
Scaling-Up Coordinated TB/HIV Treatment
In 2012, the TB CARE II project, including URC and its partners Jhpiego and the Global TB Institute (GTBI) undertook a multi-country assessment aimed at identifying some of the programmatic factors that have contributed to success in increasing the numbers of co-infected TB patients accessing ART in a timely manner. The countries selected—South Africa, Swaziland, and Zimbabwe—have developed different models for delivering TB and HIV treatment and provide important lessons to guide the further scale-up coordinated TB and HIV treatment. The assessments focused at the service delivery level in sites with evident success in order to elucidate the service delivery models used and the best field practices developed around TB/HIV integration and early initiation of ART. The lessons and practices described in each country assessment have been combined to develop a practical framework to support the implementation of service delivery interventions geared at increasing early initiation of ART for TB patients.
Addressing Delays in TB Diagnosis
Effective TB control programs require early diagnosis and immediate initiation into treatment to reduce transmission. In 2011, the USAID funded TB CARE II Project developed a framework for analyzing TB delay along with a set of tools to collect data on patient delays. TB CARE II then conducted field assessments using these tools in two high-burden TB countries— Bangladesh and Swaziland—in order to identify specific factors causing delay. The project has compiled the knowledge gained from these field assessments into a Toolkit to Address Timely TB Case Detection and Treatment. The purpose of this toolkit is to provide local TB and health program managers step-by-step assistance in understanding and identifying the possible reasons why people with TB symptoms delay in getting diagnosed and treated for TB. Additionally, the toolkit provides guidance on interventions to address these delays, emphasizing the importance of utilizing a patient-centered approach to care. Click here to access the toolkit.