Abstract
BackgroundThe overlapping epidemiology of tuberculosis (TB) and human immunodeficiency virus (HIV) infections prompted the World Health Organisation in 2004 to recommend collaboration between national TB and HIV programmes. The goal of this collaboration is to decrease the burden of both infections in the population. This policy was subsequently adopted by the national TB and HIV programmes in Cameroon with TB and HIV nurses/counsellors acting as frontline implementers of the collaborative activities in the 10 regions of the country.MethodsQualitative research interviews were conducted with 30 nurses/counsellors in four approved treatment centres providing comprehensive TB and HIV/AIDS services in the Northwest region of Cameroon. The aim was to explore their experiences in counselling, in delivering joint TB and HIV services, and the constraints to effective collaboration between TB and HIV services. To complement the findings from the counsellors' interviews, as part of an emergent design, further interviews with 2 traditional healers and non-participant observations in two HIV support group meetings were conducted.ResultsAccording to the respondents, counselling was regarded as a call to serve humanity irrespective of the reasons for choosing the profession. In addition, the counselling training and supervision received, and the skills acquired, have altogether contributed to build patients' trust in the healthcare system. Teamwork among healthcare workers and other key stakeholders in the community involved in TB/HIV prevention and control was used as a strategy to improve joint service delivery and patients' uptake of services. Several constraints to effective collaboration between TB and HIV services were identified, including shortage of human resources, infrastructure and drug supplies, poor patients' adherence to treatment and the influence of traditional healers who relentlessly dissuade patients from seeking mainstream medical care.ConclusionsIn order to achieve a sustainable collaboration between TB and HIV services, adequate planning, investment and strengthening of the health system including human resources, infrastructure and ensuring uninterrupted supplies of medicines are essential. A multidisciplinary approach to service delivery particularly focusing on harnessing the enormous potentials of traditional healers in TB/HIV prevention and control would also be indispensible.
Highlights
The overlapping epidemiology of tuberculosis (TB) and human immunodeficiency virus (HIV) infections prompted the World Health Organisation in 2004 to recommend collaboration between national TB and HIV programmes
The human immunodeficiency virus (HIV) epidemic has contributed to the upsurge of tuberculosis (TB) infections with TB being the most common opportunistic infection in people living with HIV/AIDS (PLWHA), and the leading cause of death amongst PLWHA in
Because of the overlapping epidemiology of both infections, the World Health Organisation (WHO) recommended collaboration between national TB and HIV programmes in 2004 [2]. The goal of this collaboration is to reduce the burden of TB and HIV in populations affected by both infections, and has as its objectives: i) establishing mechanisms for collaboration between national TB and HIV programmes, ii) decreasing the burden of TB in PLWHA, and iii) decreasing the burden of HIV in people with TB [2]
Summary
The overlapping epidemiology of tuberculosis (TB) and human immunodeficiency virus (HIV) infections prompted the World Health Organisation in 2004 to recommend collaboration between national TB and HIV programmes. The goal of this collaboration is to decrease the burden of both infections in the population. In connection with decreasing the burden of HIV in people with TB, WHO since 2007 recommended that counselling and testing for HIV should be offered routinely by healthcare providers to all TB patients in areas of generalised HIV epidemic, i.e. where HIV prevalence is consistently over 1% in pregnant women [4]. As regards decreasing the burden of TB in PLWHA, WHO has recommended intensified TB-case finding and treatment in HIV programmes, in addition to providing Isoniazid to prevent the development of active TB in HIV patients found to have latent TB infection [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
