PowerPoint Presentation

Review of TB-HIV Collaborative Activities1Q 2014State - Chandigarh

11State ProfilePopulation-10.9 (2014) :

TB-HIV collaborative activities started : (April- 2010 please write year of implementation)Programme Related facilities in stateNoGeneral Hospitals1Medical Colleges 2NGOs Hospital 0CHC1PHC47Urban health centres2X-Ray facilities in public sector (including those whose services are bought)9DAC Programme Related facilities in StateNoStand alone ICTC Centers12F- ICTC3PPP ICTC1Mobile ICTC1No of COE1No of pediatric COE1No of ART+ centers0ART Centers1Link ART Centers 0Link ART + Centers 0DAC Related HRDStaff Positions Number sanctionedNumber in PlaceTraining /Sensitization Timelines (M/Y)Filling VacancyPending TrainingRNTCPTB-HIVFocal point Basic Services*1 (DD(STI)1YYFocal point CST*10Focal point M&E*11YYFocal point ICTC*00Regional coordinator**11YYHIV-TB consultant**00DAPCO00District Supervisor10ICTC Counselor14+1(Mobile)15YYICTC LT14+1(Mobile)15YYSMO10MO23NNTraining planned in near futureART Counselor43YYStaff Nurse20Pharmacist11YY* Provide appropriate designation as per state rules ** wherever applicableInclude, total posts, posts vacant and training status. Under timeline please mention the approximate timeline for filling of vacancy or completing pending training

4RNTCP Programme Related facilities in stateNoNo of districts1No of TU3No of NRHM Block1No of TU aligned with NRHM Block1No of DMCs 17No.of districts linked to GeneXpert for diagnosis of TB among PLHIV-DMCs with X-ray facility5DMCs co-located with ICTCs8DMCs co-located with F-ICTCs2DMCs without HIV testing facility7S.NoDistrictTotal no of DMCsNo of DMCs not having ICTC/ FICTCName of DMCs not having ICTC/FICTC1Chandigarh 177/17Civil Dispensary -19Civil Dispensary -26

Civil Dispensary -CITCOCivil Dispensary Kajheri

Civil Dispensary -38

Civil Dispensary Dadumajra Civil Dispensary Ramdarbar

RNTCP Related HRDStaff Positions Number sanctionedNumber in PlaceTrainingTimelines (M/Y)Filling VacancyTrainingRNTCPTB-HIVState TB Officer1111NANADirector - STDCNANANANANANAEpidemiologist (APO)NANANANANANAMO State TB Cell*1100NAPlanned in 3rd week of Aug.State TB-HIV Coordinator1110NATO BE PLANNED BY AUG.DR-TB centre MO1111NA1DTO1111NA1DOTS PLUS & TB/HIV Coordinator1111NA1MO-DTC1111NA1MO-Medical college2211NAPlanned in 3rd week of Aug.* Or Focal person at state level who is handling TB-HIV portfolioInclude, total posts, posts vacant and training status. Under timeline please mention the approximate timeline for filling of vacancy or completing pending training

7State TBHIV Coordination committee meetingDate of last meeting5/8/2013Are proceedings shared with NACO and CTD? (Yes/No)yesHIV/TB Co-ordination activities: State levelAction taken on recommendations of previous meeting held on 4.10.2012Training for SMO & MO of ART Centre was successfully carried out in the month of Oct. 2012.Advocay communication Social Mobilization(ACSM) workshop for the field staff working under RNTCP and CSACS was organized in the month of Oct. 2012.

State Technical Working group meetingDate of last meeting3/2/2014Are proceedings shared with NACO and CTD? (Yes/No)YesHIV/TB Co-ordination activities: State levelAction taken on recommendations of previous STWG meeting held on 2/4/2013.Joint tour for monitoring visits of ICTCs and RNTCP facility was fixed for 2nd and 4th Tuesday.IEC material was distributed to RNTCP from CSACS.

Sr.No.Name of DistrictDate of last District Coordination Committee (DCC) meetingAre proceedings of DCC meetings received at SACS (Yes/No)Number of Monthly HIV/TB meetings conducted during the quarterNumber of monthly meetings of which, proceedings are received at SACS & STC1Chandigarh5/8/2013Yes33District Level:*use additional sheet to cover all districts in the stateJoint supervision visits conducted during the reporting quarterName of districts visited: ChandigarhDate of visit:20/5/2014, 20/6/2014 Are visit reports shared with NACO and CTD : Yes

State EvaluationsDid SACS representative participate in RNTCP internal evaluations in last six months: 1 /out of-1 total State IEs.

Joint review of District nodal officer/DTO (norm: once in six months)Is HIV/TB joint review done during the quarter: YesDid SACS representative attend RNTCP quarterly DTO review meeting: YesDid STC representative attend SACS quarterly DNO review meeting: Yes

Joint Supervision and monitoring

Action taken based on last Joint Supervision and monitoringActon taken

Recommendations

Action taken

1.IEC Material adequate: 2 weeks cough poster not mounted, hence supplied to the counselor. 2. To Increase total ICTC attendance so that the referral to RNTCP can be increased.IEC material supplied to the counsellor.The counselor was advised to improve her clientele by frequently visiting the OPD and keeping the IEC material there.Trends in referral of ICTC clients to RNTCPPlease double click on dummy chart provided13ICTC Clients referred to RNTCP, 1Q 2014 (ascending order % referral)*use additional sheet to cover all districts in the state

Name of the DistrictTotal No. of clients attending ICTC (excluding PPTCT)1Q 2014Referred to RNTCP(number)Referred to RNTCP(% )

Diagnosed TB Patients from ICTC referralChandigarh110741731.6%1Please double click on dummy chart provided

14Trends in referral from ART centre to RNTCPART Center TB- HIV Data, 1Q 2014(ascending order % detected as TB)*use additional sheet to cover all ART centres in the stateName of ART CenterNO. of PLHIV under active care as of March 2014 (a)Out of (a) No. of TB Suspects referred from ARTC to RNTCP (b)Total Diagnosed TB Pts from ARTC referral (c)Proportion detected as TB among PLHIV under active care = (c/a)PGIMER CHD212973717.4%State Total212973717.4%16Trends in Number(%) of registered TB patients with known HIV status, 1Q10 1Q141717Double click on the graph and enter data for your state in the appropriate cellsTrends in Number(%) of registered TB patients who are HIV+ve, 1Q11 1Q141818Double click on the graph and enter data for your state in the appropriate cells Number (%) of HIV+ TB patients receiving CPT during TB treatment, 1Q10 1Q131919Double click on the graph and enter data for your state in the appropriate cellsDistrict-wise Status of ART in TB-HIV Co infected Pts reg. in 1Q 2013. (Bar diagram: districts in ascending order of performance)8 co-infected patients detected in 1Q2013. All (100%) have been put on ART.Number (%) of HIV+ TB patients receiving ART during TB treatment, 1Q10 - 1Q132121Double click on the graph and enter data for your state in the appropriate cells22Trend in HIV +ve TB patients registered between 1Q13 to 1Q14 linked for Pre ART & ART initiation Treatment Outcome TBHIV: StateYearAll TB-HIV Total Case RegisteredTreatment SuccessDiedFailureDefaultTransferred outSwitch to Cat IVProportion received ART20101710(59%)2(12%)01(6%)2(12%)2(12%)17/1720112014(70%)4(20%)01(5%()1(5%)020/2020123023(75%)6(20%)1(3.3%)0.0030/30Challenges and possible solutions for PITC among presumptive TB casesPITC among presumptive TB cases not yet rolled out in Chandigarh.Preparative activities for rolling out IPTN/ACharacteristics of assessed HCF (N=total number of ART centres)

Characteristic N=1Type of facility Medical colleges 1Private tertiary -District or sub district hospital -TB hospital or clinic -Facilities with Specific high risk departments 1Status of implementation of AIC in HIV care settingPost Intervention Administrative practices in HCFIndicator N=1TB surveillance among HCW (passive or active) YesCough hygiene information in registration/waiting areas YesChest symptomatics given masks/tissues/counseling YesDustbins for disposals of any masks/tissues yesScreening and fast-tracking of chest symptomatics yesSeparation of chest symptomatics in waiting areas yesInpatient segregation practiced by nursing staffyesDesignated staff responsible for opening windows/ventsyesPost interventions: resultsIndicatorsBaseline End of 1Q14HCF with IC committee in place YesYesIC committee meet regularlyYesYesWritten IC plan availableYesYesWritten IC plan includes AICYesYesIC focal point in placeYesyesHCW surveillance (passive or active)YesYesCough hygiene informationYesYesScreening and fast-trackingYesYesSeparation of suspectsYesYesEnvironmental findingsNoIndicators(%)1Number of departments assessed1 (100%)2Minimum ACH possible with natural ventilation alone(including those where minor renovation required)13Waiting areas that need decompression or relocation1 (waiting area of ART centre lacks ventilation)4Requiring renovation to achieve minimum ACH Decompression or segregation1

29Issues in TB-HIV collaborative issuesSeparate funds to be made available for undertaking activities for TB-HIV collaborative activities. Support from CTD, DACSupport from CTD:Designated staff for TB/HIV Co-ordination.

Support from DAC:Accountability of ART and ICTC staff for TB/HIV coinfection issues.THANK YOU323232