Assessing the performance of TB-HIV activities at Masaka Regional Referral Hospital, 2012-2014

Abstract

The TB-HIV co-infection burden globally, at regional level and locally, remains a health challenge that requires strong diagnosis, treatment and integrated support. A retrospective study was carried out at Masaka Regional Referral Hospital to assess the performance of integrated TB-HIV activities between 2012 and 2014. Data were obtained from review of 1885 patients’ records and key informant interviews with 06 TB unit and 06 laboratory staff members at Masaka regional referral hospital. The percentage of TB patients who were co-infected with HIV was found to be high at 56.7% with the trends of test results showing minimum decrease over years from 2012 to 2014. As compared to WHO set targets, the average proportions of HIV testing rate among TB patients, and provision of Cotrimoxazole Preventive Therapy (CPT) were found to be very good with average recordings of 95.39% and 97.22% respectively. However, the average coverage of Anti Retro-viral Therapy (ART) among TB-HIV patients was poor at 45.90%. HIV-positive patients who were found to be free of TB disease were referred to Uganda Cares for IPT and ART. The laboratory at MRRH was found to be strengthened to improve TB case detection and offer uninterrupted services. However, the hospital had low staffing levels, received insufficient personal protective equipment, and faced congestion in the TB wards in addition to untimely delivery of laboratory supplies and delays in servicing/repair of equipment. The observed performance in terms of HIV testing and provision of CPT to TB patients was attributed to availability of qualified personnel, trainings, and laboratory equipment as well as support from NGOs like TASO, and good working environment. On the other hand, poor access to ART was mainly found to be due to poor health seeking behavior. The performance was found to be depictive of positive progress towards the World Health Organisation’s “End TB Strategy”.