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Importance of TB infection control in the fight against HIV/AIDS

by Stephen Jakes
11 Nov 2016 at 09:32hrs | Views
A senior official of the United States Centers for Disease Control and Prevention (CDC- Zimbabwe) has said the new national HealthCare Associated Tuberculosis Infection Prevention Project - Zimbabwe (HATIPP-Zim) is critical to helping Zimbabwe meet the AIDS treatment targets as it will ensure that critical staff are protected from infectious diseases such as tuberculosis.
 
"While we are all excited about the imminent launch of the Treat All strategy, incorporating the WHO 2015 guidelines to provide anti-retroviral therapy (ART) to all persons living with HIV  irrespective of eligibility criteria, this strategy will not have its intended impact without adequate human resources to execute it," said Laurie Fuller, acting Country Director of the CDC- Zimbabwe.

"By supporting HATIPP- Zim, we hope to address these challenges by exploring the option of embedding TB screening within an occupational health framework. This way, TB as well as HIV testing may be offered to health care workers within the context of overall wellness."
 
Fuller was speaking at the official launch of HATIPP- Zim last Friday in Harare. Her organization, with funding support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), is providing $1.3 million for the first year of the health initiative. The five year project will support initiatives that seek to eliminate TB infection and develop systems to protect health care workers.
 
The 2016 PEPFAR implementing plan, said Fuller, seeks to address, among other issues, staffing gaps at healthcare facilities to ensure progress towards UNAIDS 90-90-90 targets.  "As such, PEPFAR Zimbabwe is adopting innovative approaches to address human resource gaps for HIV testing, ART initiation, defaulter tracking, and adherence and retention support," she said.
 
Fuller said that the challenge remains that health care worker screening and surveillance is largely absent in thousands of facilities in Zimbabwe and across the 22 high-burden TB countries as designated by the World Health Organization (WHO). This is due to stigma associated with TB infection, among other factors. TB continues to be the leading cause of death among people living with HIV (PLHIV) in Zimbabwe and approximately 70% of Zimbabweans suffering from TB are co-infected with HIV.
 
Other speakers at the launch, who included officials from the Ministry of Health and Child Care, noted that the absence of TB infection control guidelines has led to outbreaks of drug-susceptible and drug-resistant TB in both inpatient and outpatient settings. They noted that screening of healthcare workers is one of the key elements of infection control given research findings locally and abroad that show that health care workers have a higher incidence of contracting TB than the general population.  
 
The health ministry's infection prevention and control policy recommends that health care workers be screened annually for TB infection. Dr Gerald Gwinji, Permanent Secretary in the Ministry of Health and Child Care said HATIPP Zim will support this policy.

"HATIPP-Zim will work with the ministry to develop a national health care workers TB screening policy, and standardized implementation at health facilities through strengthening occupational health services and linking the screening for TB with screening for non-communicable diseases across the country using the wellness approach model," he said. He also indicated that TB screening and treatment will be made more accessible to medical and nursing students during pre-service training.
 
HATIPP- Zim is implemented by a consortium comprised of the Biomedical Research and Training Institute (BRTI); Infection Control Association of Zimbabwe (ICAZ); and the International Union against Tuberculosis and Lung Disease (The Union).
 
The initiative is a follow up to the Zimbabwe Infection Prevention and Control Project (ZIPCOP) which ended in October 2016 and was supported by PEPFAR and CDC- Zimbabwe. ZIPCOP was implemented by the health ministry, the Infection Control Association of Zimbabwe (ICAZ), the Biomedical Research and Training Institute (BRTI).

The project led to the development of Zimbabwe's National Infection Prevention and Control (IPC) guidelines and strategic monitoring and evaluation framework, supported pre-service training on IPC, and directly supported the implementation of infection prevention and control measures in over 120 facilities across the country.
 
CDC has been operating in Zimbabwe since 2000, primarily working together with the Ministry to implement the President's Emergency Plan for AIDS Relief (PEPFAR), in response to the HIV epidemic.

 In addition to supporting the health ministry's capacity to develop evidence-based guidelines and strategies for infection prevention and control (IPC) through the Zimbabwe Infection Prevention and Control Project (ZIPCOP), the organization has supported the collection and use of health data for program management and decision making from facility to national levels, strengthening laboratory quality and capacity for patient monitoring, and building human resources for health as well as developing a national Human Resource Information System.


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Source - ZimPAS
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