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Situational Analysis for Implementing TB/HIV Surveillance in COTE D’IVOIRE

Situational Analysis for Implementing TB/HIV Surveillance in COTE D’IVOIRE. Dr AKAKI Angennes; Dr SAN Koffi / NTCP Dr EBAH Laurence; Dr TANOH Antony /ACP. TB Epidemiology. Estimated Incidence: 350- 400 cases/100,000; 150-175 new SSC+ /100,000 in 2003

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Situational Analysis for Implementing TB/HIV Surveillance in COTE D’IVOIRE

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  1. Situational Analysis for Implementing TB/HIV Surveillance in COTE D’IVOIRE Dr AKAKI Angennes; Dr SAN Koffi / NTCP Dr EBAH Laurence; Dr TANOH Antony /ACP

  2. TB Epidemiology • Estimated Incidence: • 350- 400 cases/100,000; • 150-175 new SSC+ /100,000 in 2003 • Proportion of TB patients co-infected with HIV: 46% in 2002 • DOTS: yes • Percent DOTS coverage: 74% of pop • Electronic TB reporting system: ongoing • TB data aggregated at District level were sent and compiled at national level • A new electronic TB reporting system is tested now in one TB diagnosis center in Abidjan.

  3. Estimated prevalence of HIV in general population: 9.7% in 2002 Estimated prevalence of HIV among at-risk population groups Female sex workers: 33% in 2003 HIV prevalence setting: Generalized and stable for 3 years Sources of HIV prevalence data: antenatal Electronic HIV Reporting System: Yes since the launching of the drug access initiative in 1998, the national data base is located at CDC-RETRO-CI office Could TB and HIV systems be linked? Yes HIV Epidemiology

  4. Diagnosis and Treatment (1) • Current lab capacity: • 74 TB diagnostic centers (56 functional in 2003) • 6 main regional TB clinics • 50 TB diagnosis and treatment center • 12 VCT centers ( 7 integrated ) • Current situation for HIV testing of TB patients: • Routine HIV VCT services offered in 8 main TB clinics from 1994 through 2002 (In collaboration with CDC/Retro-CI) • A devolution process of CDC/Retro-CI lab activities is on ongoing • Since 2003: 2 TB diagnosis center offer HIV VCT services ( Abidjan and Daloa )

  5. Diagnosis and Treatment (2) • Current situation for TB screening/referral of PLWHA? • All PLWHA are screened for TB (clinical, X-ray) in HIV treatment centers • All TB suspect patients are systematically referred to TB diagnosis centers • Current Treatment of PLWHA with ARVs, in particular TB Patients? • HIV positive patients eligible for ARV therapy: 126,000 (estimated number) • HIV positive patients currently receiving ARV therapy: 3,000 ( September 04) • TB/HIV positive patients receiving ARV therapy: not available

  6. Human Resources and Surveillance for TB, HIV (1) • How is surveillance conducted for HIV in TB patients, if applicable? • Routine HIV VCT services are offered in 8 main TB centers • Current human resources for HIV surveillance, TB surveillance, and TB/HIV surveillance • Health staff in the ANC and TB clinics with the support of CDC/Retro-CI

  7. Future human resource and surveillance needs for TB, HIV

  8. Other Considerations for Implementing TB/HIV Surveillance • Potential alternative surveillance approaches • Periodical survey to estimate the prevalence of TB among PLWHA • Potential Obstacles • Financial resources • Methodology/Feasibility • Human Resource requirements • According to the survey design

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