TB and TB-HIV in the

Area Surrounding St. Philip’s MissionMhlathuzeLubombo

A ministry of the Missionary Sisters of the Sacred Heart

St. Philip’s Mission, Mhlathuze

Who is Cabrini Ministries?Catholic Faith Based Organization working in area

surrounding St. Philip’s since 1971

Changing services as needs have changed

Presently seeking to respond to the needs generated by the HIV-TB pandemic surrounding St. Philip’sHealthcare exclusively for HIV/AIDS and TB patientsChildcare – for orphans and vulnerable children

Who is Cabrini Ministries?Active Partner in the Swaziland Stop TB

Partnership

Strong collaborators with the National TB Program

Partner in various other national response co-operations including:HIV/AIDS ConsortiumNCCUPartnerships with other NGOs to provide

comprehensive services

Current situation in areaFamilies overburdened Food insecurityExtreme UnemploymentLack of financial meansLack of electricityPoor roadsUnregulated costly transportLack of clean water / Lack of

waterLack of SanitationMajority of clients do not read or

write and have never left the area

Health issues in area • HIV and AIDS• TB

Health issues in area • Lack of access to

health services• Lack of follow-up• Malnutrition• Strong hold of

traditional healing, fear of other healing, fear of leaving area for treatment.

SERVICES PROVIDED TO:Anyone who wants to test

for HIV or TB in the service area

All those who are HIV or TB positive in the service area

HTC, including partial service with referral to local clinics for those outside of Cabrini service area

Presently actively serving over 2,000 HIV, AIDS, TB clients; number served increases by about 1% per month.

CM HealthcareCabrini commenced as a TB diagnostic

centre in 2010So far we have initiated 121 patients on TB

treatment73% of all TB patients are co-infected with HIV25% of all TB patients are MDR casesProvide a continuum of health care services for

HIV, AIDS, & TB patients at their homesteadsProvide access to healthcare, clinical

management and support services and ongoing community education

CM HealthcareHealth Care

Outreach for HIV, AIDS and TB - Access to Care for rural people

At Cabrini Ministries, TB care is fully integrated into HIV care

Case finding – hard, labour intensive, but possible if there is the WILL to do it.

Current healthcare services offered

HIV, AIDS, TB Education: prevention, adherence

HIV testing and counsellingTB sputum testing for every HIV+

client with TB symptomsART pre-counselling and adherence

counselling with individuals and groups; on homesteads

ART outreach centre of Sithobela HC

Current healthcare services offered

TB teaching and TB adherence teaching in the community; on homesteads

Nutrition support weekly Transport to hospital (including

chemotherapy)Home Visits daily to follow-up the very

sick, dying, defaulters PMTCT with St. Philip’s ClinicDay and overnight care as necessary at

drop-in Center

TB outreachTB fully integrated into all HIV servicesTB screening of all HIV tested and HIV positive

peopleOngoing TB screening of HIV patients on

treatment when they come in for refillsTB treatment initiation of all sputum positive

patientsVisit to patients within two weeks of TB treatment

initiation to assess progress and encourage treatment compliance

For all HIV+ TB patients the patient is prepared and initiated on HAART

TB outreachFood parcels are given to those in needDefaulters followed up through phone

calls and/or homestead visits.Provide tents where necessary to assist

with isolation of TB patients on homesteads

Transport provided to MDR patients to Moneni

Community LinkagesSince February, collaboration with 2

Government clinics (1 day per week each)SiphofaneniSinceni

to assist with HIV & TB treatment defaultersCM doctor present 1 day at each clinic for

initiation of TB and ART medication

SuccessesLess than 3% default rate for TB

treatmentAble to integrate TB and HIV

treatment activitiesLess than 1% default rate for HIV+

patients

ChallengesPatients coming very late for

treatmentReluctance by clients to start

HAART 2 weeks post TB initiationFood shortages negatively impacting

treatment compliancePill burden

SIYABONGA KA KHULU