Taking the fight where it matters; lessons gained from strengthening integration of malaria, AIDS and TB interventions through public-private networks as enduring models in Uganda from 2010-2011.

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Sebulime Gerald, Muyunga Thomas

BACKGROUND:  ‘Zero new infection, zero discrimination and zero HIV-related deaths’ is possible with strengthened Integration of malaria, AIDS and TB interventions. More than 650,000 people worldwide succumb to malaria each year almost half of these in sub-Sahara Africa (World Malaria Report, 2011). The link with HIV/AIDS, poverty and weak health systems exacerbates TB (NEJM, 2008).
METHODS: 52 grass-root community groups were mobilised and provided training to integrate malaria, AIDS and TB services. Another 60 nongovernmental organisations and CBOs engaging in provision of integrated malaria, AIDS and TB prevention services were involved. 50 health facilities were used as referral units for further management of cases. Risk populations to be targeted included: Young children, expectant women, TB patients, HIV-infected expectant women and general community members.
RESULTS:  300 key mobilisers trained in prescribing anti-malarial drugs, anti-pneumonia drugs, DOTS and adherence supports were in charge of 725 PLHIV. 50,000 brochures on malaria, AIDS and TB were provided in local languages. Schools provided spaces for 12,500 young persons to access life planning skills seminars. 20,000 insecticide treated mosquito nets were distributed. 15,000 households engaged in clean up campaigns, mobilisers promoted anti- TB drives through highlighting causes of TB. They also encouraged HCT services access and regularly engaged health workers at facilities to receive referred clients.
CONCLUSION: Integration improves early utilisation of meaningful and quality comprehensive HIV services.  Increased access to anti-retroviral therapy for TB patients who are co-infected with HIV and to chemoprophylaxis against TB for people with HIV is explored earlier.
RECOMMENDATION: Community empowerment, timely use, peer involvement and integration are key in a comprehensive prevention model that will resonate into the zero campaign.


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