This 18-month study aimed at increasing the quality and quantity of TB/HIV detection by implementing the TB testing corner at HIV C&T Center in Thai Binh city; conducting routine surveillance of HIV/TB detection and management at provincial and district health facilities and PPM activity; and organizing training on skill of TB/HIV detection and management for health staff of Thai Binh province. Key results include strengthening TB control network, treatment management, and training. A number of activities to expand TB/HIV integration were carried out, including policy development; capacity building; maintaining the continuum of care; quality assurance of services; support for public and private partnerships; strengthening the monitoring and evaluation system; and conducting information, education, and communication activities. Evaluation: The assessment looked at the capacity of TB/HIV systems; the process of implementation of HCI support at provincial and district level; the linkages developed among different stakeholders; and the impact of the interventions on the coverage and quality of TB and HIV services. The program’s degree of success was assessed by reviewing epidemiological data to provide pre- and post-intervention data on specific indicators; interviewing key informants from the National TB Program, the Thai Binh Provincial Health Services, TB hospital, the HIV/AIDS Center, and the TB/HIV coordination committee; observing of the use of instruments and equipment provided by QAP/HCI at TB hospitals and at the district level; and conducting in-depth discussions with heads of private clinics in Thai Binh City. The proportion of TB patients receiving HIV counseling increased remarkably, up to 99% in the last quarter, compared with the baseline of 47%. The HIV testing rate among TB patients also increased from 38% to 90%. TB screening was provided to 563 people with HIV during the project period, yielding TB diagnosis in 16% of screened people. With these improvements, the case detection of TB/HIV increased considerably, from only 33 patients in 2006 to 66 in 2007 and 77 in the first three quarters of 2008. The HIV prevalence among all TB patients increased from 1.9% in 2006 to 3.7% (66/1774) in 2007 and 5.4% (77/1421) in 2008 (data from first three quarters). Apart from the quality improvement of TB/HIV services, the interventions contributed to a significant improvement in overall TB case detection. The overall TB notification rate increased from 93 per 100,000 population in 2006 to 97 in 2007 and is projected to increase to 104 in 2008 (assuming 4th quarter notifications are equal to average of the first three quarters in 2008). These figures translate to an annual increase of 4.6% in 2007 and 11.7% in 2008.

Related Publication: Expanding TB and TB/HIV Integrated Services in Thai Binh Province, Vietnam