| dc.contributor |
Medical Department (HIV-TB Operational Research), Brussels Operational Centre, Médecins sans Frontières, Brussels, Belgium. zachariah@internet.lu |
|
| dc.creator |
Zachariah, R |
|
| dc.creator |
Teck, R |
|
| dc.creator |
Ascurra, O |
|
| dc.creator |
Gomani, P |
|
| dc.creator |
Manzi, M |
|
| dc.creator |
Humblet, P |
|
| dc.creator |
Nunn, P |
|
| dc.creator |
Salaniponi, F M L |
|
| dc.creator |
Harries, A D |
|
| dc.date |
2005-03 |
|
| dc.date.accessioned |
2017-01-31T07:09:10Z |
|
| dc.date.available |
2017-01-31T07:09:10Z |
|
| dc.identifier |
Can We Get More HIV-Positive Tuberculosis Patients on Antiretroviral Treatment in a Rural District of Malawi? 2005, 9 (3):238-47 Int. J. Tuberc. Lung Dis. |
|
| dc.identifier |
1027-3719 |
|
| dc.identifier |
15786885 |
|
| dc.identifier |
http://hdl.handle.net/10144/17252 |
|
| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/17252 |
|
| dc.identifier |
International Journal of Tuberculosis and Lung Disease |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17252 |
|
| dc.description |
The World Health Organization (WHO) has set a target of treating 3 million people with antiretroviral treatment (ART) by 2005. In sub-Saharan Africa, HIV-positive tuberculosis (TB) patients could significantly contribute to this target. ART (stavudine/lamivudine/nevirapine) was initiated in Thyolo district, Malawi, in April 2003, and all HIV-positive TB patients were considered eligible and offered ART. Despite this, only 44 (13%) of 352 TB patients were eventually started on ART by the end of November 2003. Most TB patients leave hospital after 2 weeks to complete the initial phase of anti-tuberculosis treatment (rifampicin-based) in the community, and ART is offered to HIV-positive TB patients after they have started the continuation phase of treatment (isoniazid/ ethambutol). ART is only offered at hospital, while the majority of TB patients take their continuation phase of anti-tuberculosis treatment from health centres. HIV-positive TB patients therefore find it difficult to access ART. In this paper, we discuss a series of options to increase the uptake of ART among HIV-positive TB patients. The main options are: 1) to hospitalise HIV-positive TB patients with a view to starting ART in the continuation phase in hospital; 2) to decentralise ART delivery so ART can be delivered at health centres; 3) to replace nevirapine with efavirenz so ART can be started earlier in the initial phase of anti-tuberculosis treatment. Decentralisation of ART from hospitals to health centres would greatly improve ART access. |
|
| dc.language |
en |
|
| dc.publisher |
International Union Against TB and Lung Disease |
|
| dc.relation |
http://www.ingentaconnect.com/content/iuatld/ijtld |
|
| dc.rights |
Archived on this site with the kind permission of the International Union Against TB and Lung Disease, http://www.iuatld.org |
|
| dc.title |
Can We Get More HIV-Positive Tuberculosis Patients on Antiretroviral Treatment in a Rural District of Malawi? |
|