Abstract
Background There is a complex interaction between infection with human immunodeficiency virus (HIV) and tuberculosis (TB) infection that results in a synergistic increase in their prevalence, morbidity, and mortality. In Ghana, 32% of TB cases were estimated to be coinfected with the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic HIV, with the highest number of coinfections in the Volta Region. This study assessed the extent of linkage between the TB and HIV collaborative activities in the South Tongu District of Ghana. Method The study employed both qualitative and quantitative methods to assess the coverage of activities to reduce the burden of TB in people living with HIV and the coverage of activities to reduce the burden of HIV in TB patients and explored the barriers to collaborative activities from the providers' perspective. Results The study showed that 344 (94.8%) HIV-positive clients were screened for TB, of which 10 (8.5%) were bacteriologically confirmed. Among those positive for TB, 6 (60%) received cotrimoxazole preventive therapy (CPT) and antiretroviral therapy. Sixty-seven (93.1%) TB patients were screened for HIV. Of these, 28 (38.9%) were retropositive, among whom 14 (50%) received anti-TB treatment. However, there were no records of isoniazid preventive therapy (IPT) for these patients. Inadequately trained personnel leading to work overload, manual record-keeping, lack of staff motivation, and absence of “enablers” packages for patients were identified as barriers to TB/HIV collaboration. Conclusion Overall, there was a moderate linkage between TB and HIV collaborative activities in the study setting. Notwithstanding, there exist some barriers that mitigate against the successful implementation of the collaborative process from the providers' perspective, hence we recommend for measures to ensure effective, efficient, and sustained integrated TB/HIV activities by addressing these barriers.
Highlights
There is a complex interaction between infection with human immunodeficiency virus (HIV) and tuberculosis (TB) infection that results in a synergistic increase in their prevalence, morbidity, and mortality [1]
As part of the policy, TB patients are to be screened for HIV and positive cases are provided with cotrimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) where indicated
In terms of access to CPT, this study found that only half of all HIV-positive TB patients registered during the period received CPT, similar to what was found in Uganda [14]
Summary
There is a complex interaction between infection with human immunodeficiency virus (HIV) and tuberculosis (TB) infection that results in a synergistic increase in their prevalence, morbidity, and mortality [1]. As part of the policy, TB patients are to be screened for HIV and positive cases are provided with cotrimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) where indicated. Despite the proven efficacy of TB/HIV treatment and prevention, studies in Ghana have found that the prevalence of HIV in TB patients is approximately 25-30% and that as many as 50% of patients with a chronic cough could be HIV positive [2]. Tuberculosis Research and Treatment difficulties for providing effective and appropriate interventions which have contributed to a lack of progress in expanding collaborative TB/HIV activities [3]. Since the national launch of TB/HIV collaborative activities in Ghana in 2007 and operation in 2009, not many studies have focused on the operational effectiveness of the integrative process, especially in the Volta Region. This study, assessed the TB/HIV collaborative activities in a district hospital in the Volta Region of Ghana
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