The Ministry of Health through Disease Control Division piloted the three ‘Is’ strategy to combat Tubercloisis (TB) in addition to its Directly Observed Therapy Short course (DOTS).

TB is the major opportunistic infection and the major source of death among people infected with HIV and AIDS. Therefore in response to the epidemic, World Health Organisation (WHO) introduced three “Is” strategy to combat TB among people living with HIV. The three “I” stand for Intensified Case Finding (ICF), Isoniazid Preventive Therapy (IPT), and Infection Control (IC).

In an interview with the Ministry of Health National TB Program (NTP) Manager Dr. Llaang Maama said the three “Is” strategy to combat TB was adopted in Lesotho by the TB/HIV collaborative Technical Working Group (TWG) to fight TB especially among HIV infected people in the country. The technical working group is comprised of Disease Control Unit of the Ministry of health, Baylor AIDS children hospital, EGPAF and ICAP.

Through the contribution of members of TB/HIV TWG, national guidelines for 3 “Is” were developed and key implementers received Training of Trainers (TOT) to be able to roll-out the strategy to the facilities.

Dr. Maama said Berea and St. Joseph hospitals will be a starting point for the implementation of the three “Is” strategy in order to document the lessons and challenges before expanding the services to the facilities countrywide.

The Berea health workers were therefore trained on March and the implementation of three “Is” commence on June 20, 2011 under the supervision of TB/HIV medical team from the Ministry of Health, EGPAF and ICAP who supervise the implementation at the ART center while the Baylor AIDS Peadiatric hospital supervises at Mother and Child Health (MCH) clinic.

During the roll-out of three “Is”, there will be Intensifying Case Finding (ICF) mission where all people come for regular check up at ART or MCH clinics will be screened for TB. Therefore those HIV infected people who are not having TB yet, will be given Isoniazid Preventive Therapy (IPT) to prevent TB related Opportunistic infection. While those who are suspected to have TB will go for sputum microscopy test for diagnosis and later receives TB treatment.

Following the Berea implementation, on July 11, 2011 the St. Joseph health workers were also trained on three “Is” guidelines to prepare them for implementation. The training is funded by Global Fund R8 TB grant with technical support from other partners. Similar supervision will be conducted during the initial stage of implementation and thereafter will be regular monitoring of the program.

With the support of development partners in collaboration with Disease Control Division of the Ministry of Health, the country is geared towards TB elimination.