The Ministry of Health and Social Welfare provides voluntary HIV Testing and Counselling  (HTC)Services to all TB patients in all health centres as part of TB/HIV collaborative effort aimed at combating the two diseases jointly.

The TB/HIV collaborative project is supported by Global Fund Round 6 TB grant whose objective is to empower people and communities with necessary skills to provide TB treatment, care and support to TB patients as well as to address TB and HIV through collaborative activities in all health sectors.

Through this grant, implementation of TB/HIV collaborative activities have been scaled-up through high uptake of HIV Counselling and Testing of TB patients, increasing number of HIV positive TB patients accessing Cotrimoxazole (fixed TB treatment) as well as enrolment of HIV positive TB patients on ART treatment.

According to disease control statistics, all the three above performance indicators have surpassed their targets more than five times. The training of community health workers and Health care workers also recorded 136% and 117% performance respectively. These training of various health cadres contributed in large extent to improve delivery of health services in both TB and HIV clinics.

Caption: TB Officer conduct health talk to TB patients at Leribe hospital. TB patient receive treatment after diagnosis.

Phoka Letuka* is HIV/TB patient who worked in South African mines and his family transferred him to the local hospital in Lesotho after being chronically ill. At hospital, he was found having TB and after being counselled, he agreed to test for HIV. This patient was enrolled on six months TB fixed dose immediately and at a time of interview he was waiting for his CD4 count to be enrolled to ARVs.

A trained Community Health Worker in Leribe Manthabileng Khoarai who is currently working at TB ward in Leribe explain one of her role is to counsel and test TB patients for HIV. "I also conduct follow ups in the community especially for those patients that do not come back for their medication and refer them to hospital to countinue their treatment,” said Mrs. Khoarai.

The Nursing Officer Mrs. Masia Khathatso mentioned that all recruitment of new TB patients are conduct from Out Patients Department (OPD) where they offer health talk to all new patients and those that are suspecting to have TB symptoms they go to TB clinic where they are given bottles for sputum test at TB laboratory. “If found with TB, the patient start visiting TB clinic but if negative the patient will go back to the OPD to see the doctor.

The Leribe TB Officer Mr. Masilonyane Thojane said it is easy to monitor patient because each patient has his/her treatment box which contain the six month treatment. Each both is written the name of the patient and the starting date of the treatment. Therefore if patients do not come back for treatment, the health worker will notice that the medication is not used in the box and make follow-up of such patients in the village.

“If the patient dies, the treatment box is cancelled and written Rest in Peace (RIP) where the drugs from that box will be taken out and used by others,” he added.

“With TB/HIV collaborative, most patients with TB are able to know their status and get help on time in order to save their lives. Most of HIV positive TB patients are now enrolled on AIDS treatment and their health has now improved,” he said.

The December 2009 report issued to GFCU from Disease Control unit of the Ministry of health reported that 2,879 TB patients received HIV Testing and Counselling up to this period, making the annual result of TB patients tested for HIV to be 10,563. Out of the tested TB patients, 2126 HIV positive TB patients received TB treatment which, cumulatively make 7,636 HIV positive TB patients annually. For the three months of October, November and December 2009, 576 HIV positive deserving TB patients were put on Antirectroviral (ARV) Therapy which make annual cumulative of 2,235 TB patients on ARV in the year 2009.

Among the Global Fund assistance under Round 6 TB grant to support combating this disease include refurbishment and upgrading of laboratories, procurement of laboratory equipments to improve TB diagnosis and monitoring. Through this grant 20 microscopists were put on board to improve analysis of TB sputum in the laboratories, 13 health educators deployed to intensify health education of TB and HIV within the community and 10 vehicles were procured to help with the follow-ups and awareness education country wide. Further more all health cadres were trained on TB and HIV to ensure effectiveness of HIV/TB collaborative activities.