Implementation of the Revised Guideline on TB/HIV Collaborative Activities in Lagos, Nigeria

Background: The National Tuberculosis and Leprosy control programme commenced the implementation of the revised national tuberculosis/human immunodeficiency virus (TB/HIV) guideline in line with the recommendations from the World Health Organization in January 2013. This study evaluated the effect of the revised guideline on the implementation of TB/HIV collaborative activities geared towards reducing the burden of HIV in TB patients in Lagos, Nigeria.
Methods: Retrospective review of presumptive and TB cases managed in TB treatment centers of the Lagos State TB and Leprosy control programme between January 1st to December 31st 2012 (pre implementation period) and January 1st to December 31st 2013 (post implementation period). Analysis was done using Statistical Package for Social Sciences (SPSS) version 19.
Results: Of the 19,533 presumptive TB cases registered during the pre implementation period 17,530 (89.7%) were offered HIV counseling and testing (HCT) out of which 15,247 (87%) accepted to be tested and 20.9% of those tested for HIV were positive. However in the post implementation period, of the 22,721 presumptive TB registered cases, 20397 (89.8%) were offered HCT and 19,264 (94.4%) accepted to be tested. Of those that were tested, 4430 (23%) were HIV positive. The proportion of TB/HIV co-infected patients enrolled on co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) during the pre and post implementation period were 76.6% vs 88.2% and 39.1% vs 49.8% respectively at p<.05.
Conclusion: There was increase in the uptake of HIV testing, ART and CPT post implementation of the guideline. Sustaining the gains of policy implementation is of utmost importance.