Feasibility of Provider-Initiated HIV Testing and Counselling of Tuberculosis Patients Under the TB Control Programme in Two Districts of South India 英文参考文献.docVIP

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Feasibility of Provider-Initiated HIV Testing and Counselling of Tuberculosis Patients Under the TB Control Programme in Two Districts of South India 英文参考文献.doc

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Feasibility of Provider-Initiated HIV Testing and Counselling of Tuberculosis Patients Under the TB Control Programme in Two Districts of South India 英文参考文献

FeasibilityofProvider-InitiatedHIVTestingand CounsellingofTuberculosisPatientsUndertheTB ControlProgrammeinTwoDistrictsofSouthIndia SophiaVijay1*,SoumyaSwaminathan2,PreetishVaidyanathan1,AleyammaThomas2,L.S.Chauhan3, PrahladKumar1,SonaliChiddarwar4,BeenaThomas2,PuneetK.Dewan5 1NationalTuberculosisInstitute,Bangalore,India,2TuberculosisResearchCentre,Chennai,India,3CentralTuberculosisDivision,DirectorateGeneralofHealthServices, MinistryofHealthandFamilyWelfare,NewDelhi,India,4MHIformotherandchild,Lucknow,India,5WorldHealthOrganization,RegionalOfficeforSoutheastAsia,New Delhi,India Abstract Background: Provider-initiated HIV testing and counselling (PITC) is internationally recommended for tuberculosis (TB) patients, but the feasibility, effectiveness, and impact of this policy on the TB programme in India are unknown. We evaluated PITC of TB patients across two districts in India considered to have generalized HIV epidemics, Tiruchirappalli (population2.5million)andMysore(population2.8million). Methodology/PrincipalFindings:StartingJune2007,healthcareprovidersinbothdistrictswereinstructedtoascertainHIV statusforallTBpatients,andreferthosewithunknownHIVstatustothenearestIntegratedCounsellingandTestingCentre (ICTC)—ofteninthesamefacility—forcounsellingandvoluntaryHIVtesting.AllTBpatientsregisteredfromJune2007to March2008werefollowedprospectively.FieldinvestigatorsassessedPITCpracticesandabstracteddatafromroutineTB programmerecordsandHIVcounsellingregisterstodeterminetheproportionofTBpatientsappropriatelyevaluatedfor HIVinfection.PatientrecordsweretracedtodeterminetheefficiencyofreferrallinkstoHIVcareandantiretroviraltreatment (ART). Between July 2007 and March 2008, 5299 TB patients were registered in both study districts. Of the 4701 with unknownHIVstatusatthetimeofTBtreatmentinitiation,3368(72%)werereferredtoanICTC,and3111(66%)werenewly testedforHIV.PITCimplementationresultedintheascertainmentofHIVstatusfor3709/5299 (70%)ofTB patients,and detected200caseswith