Reaching out to provide HIV and TB treatment in Uganda


Gloria Abiriga, a volunteer health worker, fills out a record book at the Koch Goma Health III in Amuru District.

Another volunteer health worker at the Koch Goma Health Center III trained and supported by NUMAT.
 
In Amuru District, 29-year-old Gloria Abiriga has been working as a NUMAT-supported TB focal person in Koch Goma Health Center III. Her demanding job involves counseling TB clients for HIV testing, monitoring and helping patients adhere to treatment, and training community volunteers to follow-up TB patients at their homes. After attending a specific training organized by NUMAT, Gloria uses her TB/HIV co-management and TB infection control skills when counseling and initiating HIV testing for all TB patients.

When people were living in internally displaced persons (IDP) camps set up during the conflict in Northern Uganda, patient access and follow-up care was much easier because of the close proximity of people to health facilities. Now that people are returning to their home villages, they live far away from one another and from health services, making it more difficult for them become aware of the link between TB and HIV, and access and remain on treatment. The situation threatens individual as well as community health.

NUMAT addressed this challenge by supporting health center staff and volunteers like Gloria. She was given a bicycle so that she could reach TB patients living in isolated villages every month and train other volunteers to detect and refer suspected
TB patients in their communities. Per diem has also been provided to ensure she conducts regular community sensitization meetings, follow-up of patients, and early identification of TB suspects.

More than 40,000 new cases of tuberculosis (TB) are diagnosed in Uganda every year and about 60% of them are co-infected with HIV. As a result, Uganda is encouraging health centers throughout the country to provide integrated TB/HIV services
 
“In the last two years, 50 TB patients were detected and put on treatment at the health center,” says Gloria. “As a result of NUMAT’s support to the TB clinic, we were able to test 46 of them for HIV and provide additional services to those who were found HIVpositive. Everyone is adhering well to their treatment and they complete it successfully within the scheduled time.”


Women wait outside the Koch Goma Health Center in Amuru District for TB treatment and HIV testing.
 
NUMAT continues to scale up TB and HIV services to other lower level units. Overall, the proportion of TB patients in the region who have been tested for HIV has increased from 43% in 2007 to 82% in 2011. More TB/HIV co-infected individuals are also increasingly accessing life saving interventions like cotrimoxazole prophylaxis and the antiretroviral treatment.