TB Notes Newsletter
No.
3, 2007
SURVEILLANCE, EPIDEMIOLOGY,
AND OUTBREAK
INVESTIGATIONS
BRANCH UPDATE
TB/HIV Surveillance in Ethiopia
Did you know that
Ethiopia
has “13 months of sunshine”? It’s true! The Ethiopian calendar has
12 months of 30 days each, plus an additional 13th month
with 5 or 6 days. Currently in
Ethiopia
it is 1999, and they will celebrate the millennium year (2000) this
September.
Imagine reviewing TB registers in an Ethiopian hospital, trying
to remember that March 2007 is actually written as 7/1999 in the
records! This provided an interesting challenge to me during my site
visit from March 26 to April 13 while I was working on a project for
DTBE’s International Research and Programs Branch.
The purpose of my trip was to assess TB/HIV recording procedures
in hospitals and to work with the local partners to determine ways
to improve recording of TB/HIV data. I visited eight hospitals and
one health center. Half of the sites were in the capital city,
Addis Ababa, and the others were in different regions of the
country.
Data collected
I reviewed the registers in the TB clinic and in the
antiretroviral therapy (ART) clinic at each site and attempted to
collect data on the number of--
- Persons diagnosed with TB;
- TB patients who were offered HIV testing;
- TB patients who received HIV testing;
- TB patients who were HIV infected;
- TB/HIV patients receiving ART; and
- TB/HIV patients receiving cotrimoxizole preventive treatment
(CPT) to prevent pneumonia.
Results
We were mostly interested in determining the percentage of TB
patients who were tested for HIV, since, as you may know, TB is the
number one killer of persons with HIV worldwide. In summary, for
January 2006–March 2007, I found the following average data for the
nine sites:
- 45% of TB patients were tested for HIV (range: 31%–84%)
- 36% of TB patients were infected with HIV (range: 14%–65%)
- 49% of TB/HIV patients started on
CPT (range: 15%–97%)
- 65% of TB/HIV patients started on ART (range: 16%–100%)
Many of these percentages are likely underestimates owing to
incomplete recording. Following are some of the barriers I faced
while trying to collect the data:
- The TB register provided by the Ministry of Health (MOH)
does not include a place for HIV information
- TB information is not recorded in the ART register at many
sites, even though there is a column for TB treatment in the ART
register
- Multiple registers are used at some sites
 The photo shows a coworker reviewing TB/HIV registry books at
Shashemene
Hospital, and two nurses behind him, very happy to put
on “I have TB (resources)!” buttons.
Recommendations
Based on my individual site visits and analysis of the data, I
recommended that an updated TB register be distributed as soon as
possible by the MOH, and that on-site training be provided to
hospital staff to emphasize the importance of accurate recording of
TB/HIV data and to explain how to complete the registers.
At the end of the day, the main goals are to increase the number
of TB patients tested for HIV and increase the number of TB/HIV
patients who are started on CPT and ART,
ultimately improving the health and quality of life for TB patients.
—Reported by Lauren
Lambert, MPH
Division of TB Elimination
Last Reviewed: 05/18/2008
Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
|
