Review of TB-HIV Collaborative Activities

1Q 2014
State - Chandigarh

State Profile
Population-10.9 (2014)
TB-HIV collaborative activities started
implementation)

:
: (April- 2010 please write year of

Programme Related facilities in state

No

General Hospitals

Medical Colleges

NGOs Hospital

CHC

PHC

47

Urban health centres

X-Ray facilities in public sector (including

those whose services are bought)

DAC Programme Related facilities in State

Stand alone ICTC Centers

No
12

F- ICTC

PPP ICTC

Mobile ICTC

No of COE

No of pediatric COE

No of ART+ centers

ART Centers

Link ART Centers

Link ART + Centers

DAC Related HRD

Training
/Sensitization

Timelines
(M/Y)

RNTC
P

TB-HIV

Filling
Vacan
cy

14+1(Mobil
15
Y
* Provide appropriate designation
as per state rules
e)

Staff Positions

Focal point Basic

Services*

Number
Number
sanctioned in Place

1 (DD(STI)

Focal point CST*

Focal point M&E*

Focal point ICTC*

Regional
coordinator**

HIV-TB consultant**

DAPCO

District Supervisor

14+1(Mobil
e)

15

ICTC Counselor
ICTC LT

** wherever

Pendin
g
Trainin
g

RNTCP Programme Related facilities in state

No

No of districts

No of TU

No of NRHM Block

No of TU aligned with NRHM Block

No of DMCs

17

No.of districts linked to GeneXpert for diagnosis of TB among PLHIV

DMCs with X-ray facility

DMCs co-located with ICTCs

DMCs co-located with F-ICTCs

DMCs without HIV testing facility

S.No

District

Total no
of DMCs

No of DMCs
not having Name of DMCs not having ICTC/FICTC
ICTC/ FICTC

Civil Dispensary -19

Civil Dispensary -26
Civil Dispensary -CITCO

Chandig
arh

17

7/17

Civil Dispensary Kajheri

Civil Dispensary -38

Civil Dispensary Dadumajra

Civil Dispensary Ramdarbar

RNTCP Related HRD

Number
sanctio
ned

Numb
er in
Place

State TB Officer

Director - STDC

Staff Positions

Training

Timelines (M/Y)

RNTC
P

TBHIV

Filling
Vacancy

Training

NA

NA

NA

NA

NA

NA

NA

NA

Epidemiologist
(APO)

NA

NA

NA

NA

NA

NA

MO State TB
Cell*

NA

Planned
in 3rd
week of
Aug.

State TB-HIV
Coordinator

NA

TO BE
PLANNED
BY AUG.

DR-TB centre MO

NA

DTO

NA

NA

NA

1
1
1
1
DOTS PLUS &
TB/HIV
Coordinator
* Or Focal person at state level who is handling TB-HIV
1

HIV/TB Co-ordination activities: State level

State TBHIV Coordination committee
meeting
5/8/2013
Date of last meeting
Are proceedings shared with NACO yes
and CTD? (Yes/No)

Action taken on recommendations of previous meeting held on

4.10.2012
1. Training for SMO & MO of ART Centre was successfully carried out
in the month of Oct. 2012.
2. Advocay communication Social Mobilization(ACSM) workshop for
the field staff working under RNTCP and CSACS was organized in
the month of Oct. 2012.

HIV/TB Co-ordination activities: State level

State
Technical
Working
meeting
Date of last meeting

group
3/2/2014

Are proceedings shared with NACO Yes

and CTD? (Yes/No)
Action 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.

District Level:
*use additional sheet to cover all districts in the state

Sr.
No.

Name of
District

Date of
Are
Number of
last
Number of
proceeding
monthly
District
Monthly HIV/TB
s of DCC
meetings of
Coordinati
meetings
meetings
which,
on
conducted
received at
proceedings are
Committee
during the
SACS
received at SACS
(DCC)
quarter
(Yes/No)
& STC
meeting

Chandiga 5/8/2013
rh

Yes

Joint Supervision and monitoring

Joint supervision visits conducted during the reporting quarter
Name of districts visited : Chandigarh
Date of visit
:20/5/2014, 20/6/2014
Are visit reports shared with NACO and CTD : Yes
State Evaluations
Did 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: Yes
Did SACS representative attend RNTCP quarterly DTO review meeting: Yes
Did STC representative attend SACS quarterly DNO review meeting: Yes

Action taken based on last Joint Supervision and

monitoring
Recommendations

Action taken

1.IEC Material adequate: 2 weeks

IEC material supplied to the
cough poster not mounted, hence
counsellor.
supplied to the counselor.
The counselor was advised to
2. To Increase total ICTC attendance so improve her clientele by
that the referral to RNTCP can be
frequently visiting the OPD

Acton
taken
increased.
and keeping
the IEC material
there.

Trends in referral of ICTC clients to RNTCP

25000

12

10

20000
16826
15000

13568 13644
12305

10000

16723 16933
12213

14126

17826 16931
16394 17038

19125

5000

343
318
302
302
297
262
251
242
239
208
186
188
184
1Q 11 2Q 11 3Q 11 4Q 11 1Q 12 2Q 12 3Q 12 4Q 12 1Q 13 2Q 13 3Q 13 4Q 13 1Q 14

Total No of clients attended ICTC

Number reffered to RNTCP

ICTC Clients referred to RNTCP, 1Q 2014 (ascending order

% referral)
*use additional sheet to cover all districts in the state

Name of the
District

Total No. of clients

attending ICTC
(excluding
PPTCT)1Q 2014

Referred to
RNTCP
(number)

Referred to
RNTCP
(% )

Diagnosed TB
Patients
from ICTC
referral

1
Chandigarh

11074

173

1.6%

Trends in referral from ART centre to

RNTCP

Total No of PLHIV on active care

Number detected as TB

Number reffered to RNTCP

ART Center TB- HIV Data, 1Q 2014

(ascending order % detected as TB)*use additional sheet to cover all ART centres in the state

Name of ART
Center

PGIMER CHD
State Total

Out of (a) No.

NO. of PLHIV
of TB
under active
Suspects
care as of
referred
March 2014
from ARTC
(a)
to RNTCP
(b)
212
212

97
97

Proportion
Total
detected
Diagnose
as TB
d TB Pts
among
from
PLHIV
ARTC
under
referral
active
(c)
care =
(c/a)
37
17.4%
37
17.4%

Trends in Number(%) of registered TB patients with known HIV

status, 1Q10 1Q14

1000
900
800
700
600
500

400 93%
300
200
100
0

100%
99%
98%
97%
97%
97%96%
97%
96%
96%
96%
96%
95%
94%
95%
863
839
827
795 s778
94%
734
93%
712
700
692
685
681
677
662
637
615
595 599
578 93%
539
528
508
501
92%
91%
90%

99%
98%

630
587

683
670

1Q 112Q113Q114Q111Q122Q123Q 12
4Q 12
1Q 13
2Q 13
3Q 13
4Q 13
1Q 14

Total patients registered

Number with known HIV status

Trends in Number(%) of registered TB patients who are

HIV+ve, 1Q11 1Q14

10

1.0%
9

7
4
0

8
3

2%
2%
1%
1%
1%
1%
7 1%
0%
0%
0%

1Q112Q113Q114Q111Q122Q123Q124Q121Q132Q133Q134Q131Q14

Number of HIV+ TB patients

Number (%) of HIV+ TB patients receiving CPT during TB

treatment, 1Q10 1Q13

10

120%

100%
100%
100%
100%
100%
100%
100%
100%
100%

100%
100%

100%
80%

9
5
0

6
4

60%

0%

1Q102Q103Q104Q101Q112Q113Q114Q111Q122Q123Q124Q121Q13

Number of HIV+TB patients receiving CPT

% of HIV+TB patients receiving CPT

40%
20%
0%

District-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 - 1Q13

10
9

110%

100%
100%
100%
100%
100%
100%
100%
100%
100%
100% 100%

100%

89%

90%

80%

4
3

6
4

8 70%

1
0

1Q 102Q 103Q 104Q 101Q 112Q113Q114Q111Q122Q123Q 124Q 121Q 13

Number of HIV+TB patients receiving ART

% of HIV+TB patients receiving ART

60%
50%
40%

Trend in HIV +ve TB patients registered between 1Q13 to

1Q14 linked for Pre ART & ART initiation

100%
96%

95%
92%

92%
90%
88%

89%

88%
86%

87%
85%

80%

70%
1Q2013

2Q2013

3Q2013

% of TB affected PLHV registered for Pre ART

4Q2013

1Q2014

% of TB affected PLHV receiving ART

22

Treatment Outcome TBHIV: State

All
Treatm
Died Failur Default
TBent
e
HIV Success
Total
Case
Regis
Year tered
10(59% 2(12%
2010
17
)
)
0
1(6%)
14(70% 4(20%
2011
20
)
)
0
1(5%()
1(3.3
2012
30 23(75%) 6(20%)
%)
0.

Trans Switc Proportion

ferre h to
received
d out Cat
ART
IV

2(12 2(12
%)
%)
1(5%
)
0
0

17/17
20/20
30/30

Challenges and possible solutions for

PITC among presumptive TB cases
PITC among presumptive TB cases
not yet rolled out in Chandigarh.

Preparative activities for rolling out IPT

N/A

Status of implementation of AIC in HIV care

setting
Characteristics of assessed HCF
(N=total number of ART centres)

Characteristic
Type of facility

Medical colleges

N=1
1

Private tertiary
District or sub
district hospital
TB hospital or
clinic
Facilities with
Specific high risk

Post Intervention Administrative practices in

HCF
Indicator
TB surveillance among HCW (passive or
active)
Cough hygiene information in
registration/waiting areas
Chest symptomatics given
masks/tissues/counseling
Dustbins for disposals of any masks/tissues
Screening and fast-tracking of chest
symptomatics
Separation of chest symptomatics in
waiting areas
Inpatient segregation practiced by nursing
staff
Designated staff responsible for opening
windows/vents

N=1
Yes
Yes
Yes
yes
yes
yes
yes
yes

Post interventions: results

Indicators
HCF with IC committee
in place
IC committee meet
regularly
Written IC plan
available
Written IC plan includes
AIC
IC focal point in place
HCW surveillance
(passive or active)
Cough hygiene
information
Screening and fasttracking
Separation of suspects

Baseline
Yes

End of 1Q14
Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes
Yes

yes
Yes

Yes

Yes

Yes

Yes

Yes

Yes

Environmental findings
N
o
1
2

Indicators
Number of departments assessed
Minimum ACH possible with natural
ventilation alone(including those
where minor renovation required)
Waiting areas that need
decompression or relocation
Requiring renovation to achieve
minimum ACH Decompression or
segregation

(%)
1 (100%)
1

1 (waiting area of
ART centre lacks
ventilation)
1

Issues in TB-HIV collaborative issues

Separate funds to be made available

for undertaking activities for TB-HIV
collaborative activities.

Support from CTD, DAC

Support from CTD:

Designated staff for TB/HIV Coordination.

Support from DAC:

Accountability of ART and ICTC staff for
TB/HIV coinfection issues.

THANK YOU