WHO recommended collaborative TB/HIV activities: evaluation of implementation and performance in a rural district hospital in Cameroon

In response to the need of integrating tuberculosis (TB)/HIV activities, the WHO in 2004 mapped out a number of key activities to be implemented by countries to ensure effective collaboration between TB and HIV programmes. This study assesses the performance of collaborative TB/HIV activities in Batibo District Hospital (BDH) in Cameroon, determining the prevalence of HIV in TB patients in that rural locality.

The paper indicates that among the WHO key activities there was a set of indicators for monitoring and evaluating collaborative TB/HIV activities. Accordingly, the evaluation shows that: 

• with an implementation score of 50%, the implementation of collaborative TB/HIV activities in BDH is only moderate.
• this situation in BDH is related to the technical and logistical challenges.
• however, 80% of the recommended activities to reduce the burden of HIV among TB patients were found to be implemented in BDH.
  
• the missing activity in this regard was the provision of free condoms to patients at TB unit, which is not a policy in Cameroon.

 The study draws the following conclusions:

• implementation of collaborative TB/HIV activities in BDH was moderate due mainly to the non-implementation of 'isoniazid preventive therapy' activities despite the existence of both TB and HIV units in the hospital.
• strengthening the capacity of the BDH in the so-called 3Is activities (Intensified TB case finding, Isoniazid preventative therapy, and Infection control for TB.), and particularly in ‘isoniazid preventive therapy’ services is urgently needed to achieve complete collaborative TB/HIV activities in the BDH.