Integrated tuberculosis and HIV care in a resource‐limited setting: experience from the Martin Preuss centre, Malawi
Objectives To describe the development and operation of integrated tuberculosis (TB) and HIV care at the Martin Preuss Centre, a multipartner organization bringing together governmental and non‐governmental providers of HIV and TB services in Lilongwe, Malawi.
Methods We used a case study approach to describe the integrated TB/HIV service and to illustrate successes and challenges faced by service providers. We quantified effective TB and HIV integration using indicators defined by the World Health Organization.
Results The custom‐designed building facilitates patient flow and infection control, and other important elements include coordinated leadership; joint staff training and meetings; and data systems prompting coordinated care. Some integrated services have worked well from the outset, such as promoting HIV testing among patients with TB (96% of patients with TB had documented HIV status in 2009). Other aspects of integrated care have been more challenging, for example achieving high uptake of antiretroviral therapy among HIV‐positive TB patients and combining data from paper and electronic systems. Good TB treatment outcomes (>85% cure or completion) have been achieved among both HIV‐positive and HIV‐negative individuals.
Conclusions High‐quality integrated services for TB and HIV care can be provided in a resource‐limited setting. Lessons learned may be valuable for service providers in other settings of high HIV and TB prevalence.
Document Type: Research Article
Affiliations: 1: Lighthouse Trust, Lilongwe, Malawi 2: Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom 3: Lilongwe District Health Office, Lilongwe, Malawi 4: National TB Control Programme, Lilongwe, Malawi
Publication date: 2011-11-01