| Number 27 | 25 October 2002 |
INNOVATIVE SOLUTIONS TO TRANSPORTING TB SPECIMENS
This is taken from the latest Equity Project Newsletter
Approximately 42 000 individuals are diagnosed with TB in the Eastern Cape each year. HIV, poorly managed TB programmes, and movement of people all contribute to rising TB in South Africa. As a priority programme, we need to find innovative ways to combat TB.
For the last 2 years, Samuel Ngceza has used his taxi to transport TB specimens between the Mtingwevu clinic and the Cofimvaba hospital. Launched in October 2001, the EQUITY Project and the DOH initiated the TB Taxi Project to combat transport challenges impeding effective treatment of TB in rural areas. Through this project, taxi drivers throughout the district are contracted to transport specimens between their local clinic and the Cofimvaba hospital. The joint effort of Samuel's participation and that of other drivers has resulted in improved turnaround time for specimen testing and return of results.
Due to vehicle shortages, transport of specimens in rural areas has been inefficient and irregular, with results taking between two and three weeks to return, and many not returning at all. This has serious implications for those patients who prove TB positive.
The cost-effective taxi project is set to revolutionise TB treatment. In exchange for the cost of a person seat per return trip, drivers compile a "trip sheet", signed by nurses or laboratory technicians upon collection or delivery of specimens from the relevant locations. These "trip sheets" monitor the number of trips against which drivers are paid. Biweekly deliveries for outlying clinics and daily for local clinics ensure efficient delivery and collection of results. Clinic nurses have witnessed a remarkable turnaround: drivers are so enthusiastic about the project they are acting as TB educators while transporting patients. While the EQUITY Project pays the fee to drivers, it is anticipated that local government will take over the fee, and negotiations are underway.
For more information, please visit www.equityproject.co.za
CDC SUPPORT TO SA HIV/AIDS PROGRAMME
The following provides some highlights of support from the Centres for Disease Control (CDC) to the HIV/AIDS Programme in the last few months (May - August 2002):
CDC South Africa Program Review
In July, CDC Atlanta conducted a review of CDC South Africa HIV/AIDS programs and activities. The review team met with representatives of the DOH, USAID, UNAIDS, and other academic and non-governmental organizations. Some of the problem areas identified included: 1) the need for improved surveillance data; 2) partial implementation of HIV/AIDS prevention, treatment, and care programs; 3) excessive focus on medical as compared to non-medical facilities in the current VCT program; 4) the need to overcome bureaucratic barriers to program implementation; and, 5) the need for capacity building to facilitate program implementation at local and community levels. The review team reaffirmed the major priorities of CDC South Africa which included 1) training and capacity building; 2) voluntary HIV testing and counselling; 3) monitoring and evaluation; and, 4) preventing mother-to-child HIV transmission. Other programmatic areas that could be expanded include surveillance and behaviour change interventions.
Prevention of Mother-to-Child HIV Transmission
CDC South Africa provided financial assistance to the DOH to develop, print and disseminate the following national guideline in July: A Comprehensive Package of Care for the Prevention of Mother-to-Child Transmission of HIV.
In July, CDC South Africa, in collaboration with the DOH, provided funding to the Women's Health Project to provide capacity building to support the implementation and expansion of the PMTCT programme in seven Provinces. The funding will be used to conduct a training needs assessment; create an index of training materials; assess training materials; conduct training; maintain an index of trainers and trainees, and develop evaluation tools. Persons targeted for training include health care workers, and management staff.
In August, CDC South Africa, in collaboration with the DOH, agreed to provide funding to the Human Sciences Research Council to conduct research in two provinces to assess attitudes, knowledge, practices and behaviours regarding mother-to-child HIV transmission. The research will assess several factors including factors that: 1) influence whether a pregnant women will accept to be tested for HIV, and, 2) whether and to whom she will disclose her status. Information from this investigation will be used by Provinces to expand current PMTCT services and to address such issues as stigma and discrimination.
Scientific Consultative Forum on HIV/AIDS, 13-14 August 2002
CDC South Africa provided funding to the DOH to conduct a widely publicized conference that involved approximately 100 South African researchers involved in HIV/AIDS. The participants examined current issues and research relating to HIV/AIDS including infant feeding and child health; child and adult health, treatment of HIV related opportunistic diseases, and preventing mother-to-child HIV transmission.
Recommendations from the meeting included the expansion of the PMTCT program including antiretroviral therapies such as nevirapine; developing pilot programs for the use of anti retroviral therapies in both adults and children; reviewing and implementing improved strategies for safe infant feeding; expansion of current HIV/AIDS biologic and behavioural surveillance; expanded training programs for health care workers to diagnose and treat HIV related opportunistic infections; revision of current clinical guidelines for the management of opportunistic infections and HIV/AIDS (including ARV use); and, improved laboratory organization and support for clinical services. This conference provided an important opportunity to facilitate collaboration between researchers and the DOH and between researchers themselves. CDC South Africa will provide support to print and disseminate the proceedings of the conference and for follow up meetings.
RHRU REPRODUCTIVE HEALTH PRIORITIES CONFERENCE
The 8th RHRU Reproductive Health Priorities conference was held from 1-4 October 2002 at the Wild Coast Sun. Most of the contents focused on HIV/AIDS issues, with parallel sessions on PMTCT, adolescent health, STIs etc. Participants were drawn from South Africa as well as other African countries, and approximately 390 people registered for the conference.
There were several very interesting presentations, and these should be available on the RHRU website by the end of the month. Some very interesting presentations that you could look out for include the following:
There was also a very interesting (interactive) panel discussion on the last day relating to ethics in health care. It provided a platform for several people to share their views, and as such made the participants ponder some very challenging issues.
Please check the RHRU website regularly for further information: www.rhru.co.za
USEFUL WEBSITES
www.health.gov.za
www.aidsinfo.co.za
www.aidsdirectory.co.za
www.dpp.org.za
www.hst.org.za
www.lovelife.org.za
www.childaidsservices.org
www.equityproject.co.za
www.unaids.org
You are also encouraged to share information on other useful websites. Feedback on the Department of Health website would be especially valuable.
Compiled by Celicia M Serenata
Project Manager: HIV/AIDS
Tel: (012) 312-0128
Fax: (012) 326-2891
e-mail: serenc@health.gov.za
Red Ribbon Resource Centre
For all requests of HIV/AIDS materials (posters etc.), please contact:
Tel: (011) 880-0405
Fax: (011) 880-8552
Address List for Chief Directorate
Fax: (012) 326-2891 or (012) 323-7323
Dr. Nono Simelela
Chief Director: HIV/AIDS and TB
Tel: (012) 312-0121
simeln@health.gov.za
Collen Bonnecwe
Director: HIV/AIDS (NGOs)
Tel: (012) 312-0137
bonnec@health.gov.za
Thami Skenjana
Director: GAAP
Tel: (012) 312-0133
Fax: (012) 325-0165
Dr. Refiloe Matji
Director: TB
Tel: (012) 312-0106
Fax: (012) 326-4365
matjir@health.gov.za
Dr. Rose Mulumba
Director: HIV/AIDS and STIs
mulumr@health.gov.za