Cross-referral between HIV counselling and testing centres and smear microscopy centres in Tamil Nadu

Ramachandran, R and Chandrasekaran, V and Muniyandi, M and Jaggarajamma, K and Bagchi, A and Sahu, S (2009) Cross-referral between HIV counselling and testing centres and smear microscopy centres in Tamil Nadu. International Journal of Tuberculosis and Lung Disease, 13 (2). pp. 221-225. ISSN : 1027-3719; EISSN: 1815-7920

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BACKGROUND: The combined tuberculosis and human immunodefi ciency virus (TB-HIV) epidemic demands effective and urgent action. OBJECTIVE: To assess the effectiveness of the system of referral of TB suspects from the integrated HIV counselling and testing centres (ICTCs) to the designated microscopy centres (DMCs) in Tamil Nadu, and to identify reasons for dropping out. DESIGN: ICTC counsellors identifi ed TB suspects among clients (excluding pregnant women and children) in six districts of Tamil Nadu in 2007 and referred them to DMCs, irrespective of their HIV status. From the records at ICTCs and DMCs, we collected information on the number of referrals to the DMCs, TB suspects attending DMCs and smear-positive TB cases with or without HIV. Clients who did not attend the DMCs were interviewed to elicit reasons for dropping out. RESULTS: Of 18 329 clients counselled, 1065 (6%) were identifi ed as TB suspects and referred to DMCs. Of these, 888 (83%) attended and 177 (17%) dropped out; 81% of the drop-outs were interviewed. Reasons for dropping out were multiple: 51% were due to the health system, 62% due to the disease and 62% due to personal reasons. Twelve per cent of DMC attendees were smear-positive. CONCLUSION: The ICTC-to-DMC referral system makes a signifi cant contribution to the detection of TB cases. Reasons for dropping out were multiple, but are correctable. This study also probes into current policies on programme coordination and recommends strategies for strengthening the collaboration between the TB and HIV programmes.

Item Type: Article
Uncontrolled Keywords: ICTC clients; DMC referrals; tuberculosis; HIV; drop-outs; India
Subjects: Tuberculosis > Socio Behavioral
Divisions: Social and Behavioural Research
Depositing User: Dr. Rathinasabapati R
Date Deposited: 03 Aug 2017 11:14
Last Modified: 03 Aug 2017 11:14

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