Scale up of collaborative TB/HIV activities in Kenya

Dr. Joseph Sitienei

NATIONAL TB PROGRAM KENYA

Kenya: Profile

Population 33.4 Million

TB CDR (WHO-2004) estimate 46%

Incidence of TB (2005) 108,401

Case Notification Rate (2005) 325/100,000

HIV prevalence (KDHS 2003) 6.7%

TB patients with HIV (2005) 57%

TB HIV: MilestonesDATE ACTIVITY

1994 HIV sero prevalence in SMP TB cases (50% Positive)

1997 and 1998 Attempts at tackling TBHIV Issues: 2 meetings

Oct. 2004 Policy on Testing HIV in clinical settings released

Nov. 2004 National TB HIV steering committee in place

Jan- June 2005 •Revision of TB Data tools, printing and dissemination•TB HIV curriculum Development •TB HIV guidelines adopted locally•Training of health care workers•Province/District TB HIV steering committees set up

Nov 2004 ToT’s trained: • First June 2005•Second May 2006

Oct 2006 Printing of the TB HIV training curriculum

TRAINING OF HEALTH CARE WORKERS

Implementation of new RR

62

88

57

84

0

20

40

60

80

100

120

Q3/05 Q4/05 Q1/06 Q2/06

Quarter/Years

Perc

enta

ge

Percent reported with new RR

Percent districts using new RR

Scale up of HIV Testing in TB patients

32

41

50

59

80

0

10

20

30

40

50

60

70

80

90

Q3/05 Q4/05 Q1/06 Q2/06 Q4/06Target

Quarter/year

Pe

rce

nt

TB

pa

tie

nts

te

ste

d

Trend of HIV Testing amongst TB patients

6288 100 100

32 41 50 59

0

50

100

150

Q3/ 05 Q4/ 05 Q1/ 06 Q2/ 06

Quar ter / Year

%age offered HIV testing %age tested for HIV

HIV Positive TB cases: Trends

60

55 55

53

48

50

52

54

56

58

60

62

Q3/05 Q4/05 Q1/06 Q2/06

Quarter/Year

Kenya & Provinces, %-tage TB cases tested for HIV: Qrts. 3-4/2005, 1-2/2006

0 10 20 30 40 50 60 70 80 90 100

Nairobi

Central

Coast

Eastern South

Eastern North

North Eastern

Nyanza

Rift Valley South

Rift Valley North

Western

Kenya

Pro

vin

ce

s/K

en

ya

%-tage tested

Qrt2/2006

Qrt 1/2006

Qrt 4/2005

Qrt 3/2005

Kenya & Provinces, %-tage TB cases tested HIV+: Qrts. 3-4/2005, 1-2/2006

0 10 20 30 40 50 60 70 80 90 100

Nairobi

Central

Coast

Eastern South

Eastern North

North Eastern

Nyanza

Rift Valley South

Rift Valley North

Western

Kenya

Pro

vin

ce

s/K

en

ya

%-tage HIV+

Qrt2/2006

Qrt 1/2006

Qrt 4/2005

Qrt 3/2005

Kenya - 2nd quarter 2006 - HIV testing and HIV+ per type of TB

62%59% 59% 57%

53%

46%

57%59%

53%

69%

58%

63%

44%

49%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Relap

se P

TB+

Relap

se P

TB-/EPTB

Retx

Failu

res

Return

afte

r Def

ault

Total R

etre

atm

ent

PTB+

PTB>15

yrs,

sm

ear n

ot done

New P

TB- <15

yrs

PTB- >15

yrs

Total P

TB-

EPTB <15

yrs

EPTB >15

yrs

Total E

PTB

Total T

B cas

es

Type of TB

%

% tested for HIV

% tested HIV+

HIV testing uptake: M/ F

28

39

4855

0

10

20

30

40

50

60

Q3/05 Q4/05 Q1/06 Q2/06

Quarter/ Year

%ge M/ F PTB+

HIV prevalence among TB patients: Age/Sex distribution: 2005

0

10

20

30

40

50

60

70

HIV

pre

vale

nce

15-24 25-34 35-44 45-54 Overal

Age groups

Male Female

Linkages

NLTP Targets

• HIV testing of TB patients to 80%

• Ensure 80% HIV+/TB patients on cotrim

• Ensure 80% of HIV+ TB patients on ARV’s

• Ensure at least 20% of PLHWA screened for TB

CPT/ ART linkages

98

7084 87

3828 29 25

020406080

100120

Q3/05 Q4/05 Q1/06 Q2/06

Quarter/Year

%age on CPT

%age on ART

Where we are in 2006 Quarter 2

• HIV testing in TB patients - 60%

• More than 80% HIV+ TB patients on CTX

• HIV+ TB patients on ART 25%

ACKNOWLEDGEMENTS• Ministry of health

• The NLTP at all Levels: – National, – Provinces and Districts

• The TB Patients

THANK YOU FOR

LISTENING TO ME