HIV/TB Co-Infection Programs

Tuberculosis and HIV in Botswana
HIV and TB together form a lethal combination in sub-Saharan Africa. HIV-infected individuals are more susceptible to developing TB disease, and TB worsens outcomes in HIV patients.
Caring for patients with TB-HIV co-infection is also complicated by increased drug-drug interactions, overlapping drug toxicities, problems of high pill burden and adherence, and paradoxical reactions.

 

Epidemiology of TB
1/3 of the world is infected with tuberculosis (Source: WHO)
1.6 million people died from TB in 2005 (estimated 4400 deaths a day)
HIV is the main cause for the increasing incidence of TB in Botswana
80% of TB patient in Botswana are co-infected with HIV (source CDC)
TB is the leading cause of death of people living with HIV in Botswana

Annual TB incidence (cases per 100,000, source WHO 2005)
Botswana: 654 (4th highest in the world)
African average: 343
USA: 5

 

Problems facing the control of TB in Botswana:
Integrating the care of TB and HIV
Obstacles to effective diagnosis and case-finding
Laboratory infrastructure
Maintaining adequate supplies of ant-tuberculous drugs
Lack of infection control
Growing prevalence of drug resistant TB
Problems with recording and reporting
Shortage of human resources

 

UPenn TB-HIV Program
(Initiated in 2006, Funded by PEPFAR)
Specialty clinic for patients co-infected with HIV-TB and those suffering from multi-drug resistant TB
TB case-finding and counseling services
Inpatient and outpatient diagnostic support services
Educational support, training, and TB curriculum development
Community outreach to nearby villages (Mochudi, Molepolole, Lobatse, Kanye)
Development of national HIV and TB guidelines
Advise on the implementation of infection control measures
Inform national TB policy in collaboration with ministry of health

 

Useful TB-HIV Links:

WHO TB Initative

CDC TB

International Union Against Tuberculosis and Lung Disease