One of the important features of a successful NTP is integration of TB control activities with the general health services (see Chapter 2).This means that at the district and primary health care levels, the general health service staff manage TB patients according to NTP guidelines. NTP staff provide support.
General health service staff and NTP staff need to know what local HIV/AIDS services are available for HIV-positive patients.The Ministry of Health may run a system for accreditation of the range of local providers of HIV/AIDS services. They include the government, nongovernmental organizations (NGOs), community organizations, private practitioners and employer health services. Often it is possible to refer patients directly to these providers of HIV/AIDS services.
Some TB/HIV patients choose not to accept referral to HIV/AIDS services. It is important to respect patients' wishes and confidentiality. In many districts there is a district coordinator for HIV/AIDS. District NTP staff liaison with the district coordinator for HIV/AIDS promotes the easy referral of TB/HIV patients to HIV/AIDS services.
In many towns and cities there are now HIV counselling and voluntary testing centres. Some of the people attending these centres may have TB. A study in Kampala, Uganda, showed that 6% of people attending the HIV counselling and voluntary testing centre had undiagnosed TB. NTP collaboration with these centres is important. Staff in the centres should ask clients about chronic cough and refer TB suspects to the NTP for sputum microscopy.
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