Strengthening Public Health
Systems and Services -
Care and Treatment
Care and treatment initiatives provide hope to adults and
children living with HIV/AIDS through the provision of services that support
quality of life, including life-saving
antiretroviral therapy (ART).
Early Infant Diagnosis: Left unidentified and untreated, studies show that 50-60% of HIV-infected infants die by age two. Early Infant Diagnosis (EID)
by dried blood spot (DBS) gives HIV-infected infants early access to appropriate
care and treatment. With the simple prick of an infant’s heel, toe, or finger,
whole blood is placed onto a card to dry, creating samples which are stable for
relatively long periods without refrigeration, and are light and simple to
transport. CDC has worked with partners to implement and expand EID services in
15 countries.
Basic
Care Package: CDC led operational research conducted in rural Uganda and
elsewhere that integrates a package of interventions (Basic Care Package) to
minimize the susceptibility of HIV persons to common opportunistic infections
and unsanitary water. This research demonstrated that this integrated package
can help reduce deaths, hospital visits, and illnesses, including malaria and
diarrhea, among HIV-positive people and their families. The Basic Care Package
is a low-cost, evidence-based way to promote health and reduce HIV/AIDS
infections. The package includes insecticide-treated mosquito nets; water
vessel, filter cloth, and bleach solution to disinfect water; information on how
to obtain HIV family counseling, HIV testing services; and cotrimoxazole -- an
antibiotic that reduces opportunistic infections among HIV positive persons.
After six months of implementing the Basic Care program in Uganda, CDC found
that over 90 percent of recipients used cotrimoxazole prophylaxis every day and over 60 percent of
the respondents used the water vessel. CDC is also now providing Basic Care
Packages in other countries in the region.
Pediatric
HIV Treatment: CDC helped develop teams of physicians, nurses, counselors,
pharmacists, and persons living with HIV/AIDS (PLWHA) in 12 community
hospitals in Thailand’s Chiang Rai province. For the few pediatricians
skilled in providing antiretroviral therapy (ART), the multidisciplinary
approach is a way to extend their reach and reduce their workload.
Although almost all HIV-infected children in Thailand can receive treatment through the national ART program, care networks face challenges such as pain management, stigma, and poor transportation systems marked by winding mountain roads. But thanks to the collaboration between specialists and the local community, these problems are being addressed. The comprehensive team approach and two inexpensive plastic devices that help children stick with ART -- wrist watches that beep every 12 hours, and 7-day pillboxes -- are resulting in high adherence rates. The rate-more than 95 percent in most patients -- is better than that found in most developed countries.
Tuberculosis
(TB) is the leading cause of death among HIV-infected individuals, and one of
the most common opportunistic infections. The prevalence of HIV infection among
patients in TB clinical settings is high-- up to 80 percent in some countries.
In many countries, including Botswana, Ethiopia, Kenya, Rwanda, Tanzania, and
Thailand CDC
has worked with partners to support the expansion of provider-initiated testing
and counseling among TB patients, and collaborated with international partners
to develop and disseminate protocols, training and policy to improve the
integration of HIV and TB service care.
Through the President's Emergency Plan for AIDS Relief (PEPFAR), and in collaboration with U.S. government partners, host governments, ministries of health, non-governmental organizations, international organizations, U.S.-based universities, and the private sector, CDC:
Builds Capacity for HIV Care and Treatment- Assists countries to plan, implement, and evaluate effective strategies for HIV care and treatment.
- Provides HIV care and treatment expertise to partners on management, standard operating procedures, human resources, physical infrastructure, training, laboratory services, monitoring and evaluation, community services, linkage with HIV and other programs, promotion of prevention, and sustainability.
- Develops, disseminates, and provides training on global palliative care and ART tools, guidelines, and policies.
Bolsters Prevention of Mother-to-Child Transmission Programs and Pediatric Services
- Provides technical assistance for scale-up of prevention of mother-to- child transmission (PMTCT) and pediatric activities and linking PMTCT and pediatric HIV programs with other services.
- Contributes to the scientific body of knowledge on global PMTCT and pediatrics and develop and disseminate tools, guidelines, and policies to translate research for improved program implementation in resource-constrained countries.
- Conducts public health evaluations to promote best practices, address barriers, and respond to emerging scientific issues for PMTCT and pediatric HIV service delivery.
Strengthens TB/HIV Programs
- Provides technical assistance for scale-up of TB/HIV activities, including HIV testing and counseling, referral, and care and treatment among TB patients.
- Helps countries develop national and regional guidelines for HIV-related TB diagnosis, treatment and prevention.
- Strengthens awareness and implementation of basic TB infection control in HIV care and treatment settings.
Haiti, Trinidad and Tobago, and 13 African Countries
Early Infant Diagnosis: Left unidentified and untreated, studies show that 50-60% of HIV-infected infants die by age two. Early Infant Diagnosis (EID)
by dried blood spot (DBS) gives HIV-infected infants early access to appropriate
care and treatment. With the simple prick of an infant’s heel, toe, or finger,
whole blood is placed onto a card to dry, creating samples which are stable for
relatively long periods without refrigeration, and are light and simple to
transport. CDC has worked with partners to implement and expand EID services in
15 countries.
Uganda
Basic
Care Package: CDC led operational research conducted in rural Uganda and
elsewhere that integrates a package of interventions (Basic Care Package) to
minimize the susceptibility of HIV persons to common opportunistic infections
and unsanitary water. This research demonstrated that this integrated package
can help reduce deaths, hospital visits, and illnesses, including malaria and
diarrhea, among HIV-positive people and their families. The Basic Care Package
is a low-cost, evidence-based way to promote health and reduce HIV/AIDS
infections. The package includes insecticide-treated mosquito nets; water
vessel, filter cloth, and bleach solution to disinfect water; information on how
to obtain HIV family counseling, HIV testing services; and cotrimoxazole -- an
antibiotic that reduces opportunistic infections among HIV positive persons.
After six months of implementing the Basic Care program in Uganda, CDC found
that over 90 percent of recipients used cotrimoxazole prophylaxis every day and over 60 percent of
the respondents used the water vessel. CDC is also now providing Basic Care
Packages in other countries in the region.Thailand
Pediatric
HIV Treatment: CDC helped develop teams of physicians, nurses, counselors,
pharmacists, and persons living with HIV/AIDS (PLWHA) in 12 community
hospitals in Thailand’s Chiang Rai province. For the few pediatricians
skilled in providing antiretroviral therapy (ART), the multidisciplinary
approach is a way to extend their reach and reduce their workload. Although almost all HIV-infected children in Thailand can receive treatment through the national ART program, care networks face challenges such as pain management, stigma, and poor transportation systems marked by winding mountain roads. But thanks to the collaboration between specialists and the local community, these problems are being addressed. The comprehensive team approach and two inexpensive plastic devices that help children stick with ART -- wrist watches that beep every 12 hours, and 7-day pillboxes -- are resulting in high adherence rates. The rate-more than 95 percent in most patients -- is better than that found in most developed countries.
Botswana, Ethiopia, Kenya, Rwanda, Tanzania and Thailand
Tuberculosis
(TB) is the leading cause of death among HIV-infected individuals, and one of
the most common opportunistic infections. The prevalence of HIV infection among
patients in TB clinical settings is high-- up to 80 percent in some countries.
In many countries, including Botswana, Ethiopia, Kenya, Rwanda, Tanzania, and
Thailand CDC
has worked with partners to support the expansion of provider-initiated testing
and counseling among TB patients, and collaborated with international partners
to develop and disseminate protocols, training and policy to improve the
integration of HIV and TB service care.
Last modified:
October 24, 2008
Last reviewed: August 27, 2008
Content Source:
Global AIDS Program (GAP)
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Last reviewed: August 27, 2008
Content Source:
Global AIDS Program (GAP)
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention