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National TB/HIV co-infection rate sees decline– NAPS Prog. Director
The co-infection rate of Tuberculosis (TB) and the Human Immunodeficiency Virus (HIV) continues to be
NAPS Programme Manager, Dr Shanti Singh
a challenge for the Ministry of Health’s National AIDS Programme Secretariat (NAPS). However, according to NAPS Programme Manager, Dr. Shanti Singh, this state of affairs is not unique to Guyana as it obtains in many other countries.
She however noted that what is significant for Guyana is that there has been a reduction of TB over the years. Although unable to give precise figures in this regard, Dr. Singh was confident enough to disclose that there is evidence to support particular reductions over the course of 2013 and 2014.
The parallel outcome, she added, was a 22 per cent TB/HIV co-infection rate in 2014 down from 25 per cent in the previous year. “It may seem as if it is an insignificant drop but for us this is a really significant drop…to move from 25 to 22 per cent in a one-year period,” asserted Dr. Singh.
According to her, in order to make such a conclusion, efforts would have been made to observe the downward trend over a period of time. “We have seen that downward trend of the TB/HIV co-infection rate and while it might not be major, it still qualifies as a downward trend because it is a really difficult area to work in,” said Dr. Singh.
This, she noted, is in light of the fact that many TB patients also have social issues to contend with thus, putting them at greater risk. These social issues can range from homelessness to substance abuse which can be compounded by the fact that the disease, even today, attracts a great deal of stigma and discrimination.
Nevertheless, the NAPS Programme Manager related that fervent and consistent efforts are being directed towards the reduction of the TB co-infection rate.
Currently, the Ministry is embracing some strategic tactics to help with this process, according to Dr. Singh. She alluded to the use of prophylaxis and infection control which she described as “very big for us.”
The prophylaxis approach is one that NAPS is undertaking in close collaboration with the National TB Programme. “That is going to be another important undertaking in this year, whereas, before we would have administered Tuberculin Skin Test (TST) on persons to determine if they have the TB infection and then work to rule out active TB,” explained Dr. Singh.
However, the protocol under consideration right now, is to see whether or not these patients have TB without doing a TST. Once this protocol is implemented, efforts can be made to rule out TB and a patient can be automatically placed on prophylaxis.
The Ministry, according to her, has in place an Infection and Control Department that comes under Standards and Technical Services and that Department is tasked with working along with the TB/HIV programme in terms of strengthening infection control in both the TB and HIV Clinics.
Dr. Singh moreover noted that as part of the efforts to strengthen infection control, efforts are being made to give attention to some very basic things that can help to reduce the transmission among the HIV positive patients population.
Guyana’s report on HIV/TB at a time when the Pan American Health Organisation/World Health Organisation (PAHO/WHO) has observed that although there continues to be significant progress in reducing the burden of TB, along with HIV/AIDS, it continues to be one of the region’s leading infectious causes of death.
According to PAHO/WHO, some 17,000 people in the Americas died of Tuberculosis (TB) complications in 2013 and these were among the more than 285,000 infected with TB.
In fact PAHO/WHO has declared that that 31,800 people (in the Americas) with HIV also developed TB.
In fact it was disclosed that countries in the Americas reported 220,500 new cases of TB cases in 2013 of which 5.3 per cent (11,379) were children. Accounting for the largest proportions of the Region’s cases were Brazil with 33 per cent, Peru with 13 per cent, Mexico with 8.8 per cent and Haiti 7.4 per cent.
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