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Free Content Integration of tuberculosis and prevention of mother-to-child transmission of HIV programmes in South Africa

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SETTING: One of the rural districts in KwaZulu-Natal Province, the epicentre of the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics in South Africa.

OBJECTIVES: To assess the integration of TB services into the prevention of mother-to-child transmission of HIV (PMTCT) programme and identify barriers to the integration of services.

DESIGN: Cross-sectional survey using exit interviews with pregnant women attending 10 antenatal care (ANC) clinics. Review of ANC PMTCT facility routine data. Qualitative interviews with 26 key informants on barriers to integration of TB-PMTCT services.

RESULTS: Of 150 women interviewed, 112 (75%) reported being educated on TB symptoms on the day of their visit; 56% were screened for TB symptoms and 27% were suspected to have TB; 26 (17%) women were HIV-positive and 2 (8%) were co-infected with TB. There was no record of provision of isoniazid prophylaxis for PMTCT clients with latent tuberculous infection. The predominant barriers to the integration of TB-PMTCT services included lack of skilled providers and their supervision, the physical layout of the TB-PMTCT services and the service delivery mechanisms.

CONCLUSION: The integration of TB prevention and care into the PMTCT programme was inadequate. Integration of TB services into the ANC PMTCT programme will require strong leadership to address barriers such as training gaps, lack of supervision and service delivery mechanisms.
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Keywords: antenatal care; integration barriers; tuberculosis

Document Type: Research Article

Affiliations: 1: School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa; School of Public Health, National University of Rwanda, Kigali, Rwanda 2: School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa

Publication date: October 1, 2013

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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