http://www.aidsmap.com///page/1506853/ http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ As Professor van der Walt said in an interview with me at the South African TB conference, there is a push to get South Africa to provide continuous isoniazid preventive therapy (IPT) to people with HIV without symptoms of TB. Theo Smart http://www.aidsmap.com///page/2441242/ Anon http://www.aidsmap.com///page/2438662/ A new tool to assist primary health care nurses managing TB & TB-HIV Theo Smart http://www.aidsmap.com///page/2436905/ "This conference is on tuberculosis TB/HIV integration but when you can actually look at what is going on in the health services over all, there's very little integration really," said Professor Martie van der Walt, who currently heads the TB research unit of South Africa's Medical Research Council. Theo Smart http://www.aidsmap.com///page/2433907/ The advocacy pre-meeting at the South African TB Conference started with a presentation on GeneXpert and the need for affordable TB diagnostics by Colleen Daniels, formerly with WHO's STOP TB Department, but now the Senior Policy Associate for TB with the Treatment Action Group (TAG), a rather remarkable coup for the organisation. She provided some interesting data on the early uptake of the Xpert MTB/Rif test for TB, which was covered in a recent series of HATIP editions. Theo Smart http://www.aidsmap.com///page/2398133/ Participants at the Treatment Action Campaign, SECTION27, Médecins Sans Frontières and Oxfam pre-meeting we mentioned last week identified five crucial interventions to reduce TB cases and mortality in South Africa. Theo Smart http://www.aidsmap.com///page/2397011/ WHO's STOP TB programme is organising a consultation immediately prior to AIDS 2012 in Washington DC, in order to generate innovative ideas on the next ten years of the HIV/TB response. The consultation will be co-hosted by Diane Havlir of University of San Francisco and the Chair of the Global TB/HIV Working Group and co-Chair of AIDS 2012 and Mark Dybul of the Georgetown University and George W Bush Institute and formerly the US Global AIDS Coordinator, and convened by Haileyesus Getahun of the Stop TB Department of WHO. Anon http://www.aidsmap.com///page/2396893/ Whenever a major HIV and TB conference takes place in South Africa, one has come to expect a significant activist presence - and at least under the current minister of health - engagement. With groups like the Treatment Action Campaign (TAC) - arguably the most renowned treatment activist organization since ACT UP New York - and its natural allies, Médecins sans Frontières (MSF) and Section 27 (the legal wonks formerly known as the AIDS Law Project), activism and campaigns are sometimes as much on show as the clinical science - and often far more impactful. Theo Smart http://www.aidsmap.com///page/2393547/ A key issue expected to be highlighted at the 3rd South African TB Conference this week in Durban is demand for new TB diagnostics and new approaches to managing TB. Theo Smart http://www.aidsmap.com///page/2389911/ Anon http://www.aidsmap.com///page/2384914/ We'd like to draw attention to events at several upcoming conferences, and to remind you that registration for the 43rd Union World Conference on Lung Health is now open. Keith Alcorn http://www.aidsmap.com///page/2382048/ A new practical guide for healthcare workers and HIV and tuberculosis (TB) programmes on how to implement TB-HIV collaborative activities (health services that reduce the burden of either TB or HIV, and sometimes both diseases, as well as the activities required to support those services) has just been released by the the Union (the International Union Against Tuberculosis and Lung Disease). Theo Smart http://www.aidsmap.com///page/2368779/ One of the 'discussions in the corridors' at the Union World Conference on Lung Health in Lille in October last year, was about the ethics of a study known as 'ACTG 5274' or the 'REMEMBER' trial. REMEMBER stands for 'Reducing Early Mortality and Early Morbidity by Empiric Tuberculosis (TB) Treatment Regimens'. Giving someone 'empiric' treatment means treating them for something they might have, before it has been confirmed. The study was described in this blog a couple of months ago - it is recruiting people with HIV who present late for care (e.g. are diagnosed with a CD4 cell count below 50). In the study, people are randomly assigned to one of two groups: Theo Smart http://www.aidsmap.com///page/2367222/ Funding opportunity for proposals to increase access to TB, HIV and malaria medicines, treatment and diagnostics in low and middle-income countries - deadline 22 May 2012 Theo Smart http://www.aidsmap.com///page/2356474/ Any setting where there is a significant burden of drug resistant TB would do well to adopt the key steps being taken in Mumbai. Anon http://www.aidsmap.com///page/2271833/ "It is still possible for public health systems to take a pro-active step, as the Mumbai officials are now doing to stem the problem," Dr Dewan told India Together. "TB Control in Mumbai can be transformed. The challenge is to ensure that all TB patients get the support they need and that would prevent the emergence of drug resistance strains." Theo Smart http://www.aidsmap.com///page/2271801/ To coincide with World TB Day, members of WHO's STOP TB Department published a piece in a special Tuberculosis and TB/HIV Supplement of the Journal of Infectious Diseases that lays out the case for improving access to TB prevention, diagnosis and treatment services for pregnant women and their children. They call for the following "low-cost, effective interventions" to be made a routine part of the integrated management of pregnancy and child health in much the same way as TB collaborative activities are now part of standard of care for HIV programmes in resource-constrained settings. Theo Smart http://www.aidsmap.com///page/2328055/ In the last post, we reviewed the backstory regarding a report in Clinical Infectious Diseases by Udwadia et al on the detection of TB cases at a hospital in Mumbai, India, that lab tests suggested were resistant to all of the anti-TB medications the hospital could get hold of, and which were thus classified as being totally drug resistant-TB (TDR-TB). Theo Smart http://www.aidsmap.com///page/2270555/ In what is by now old news, a little more than a month ago, a report in the journal Clinical Infectious Diseases from a hospital in Mumbai, India, described several cases of tuberculosis that drug sensitivity testing (DST) in the facility's lab suggested were resistant to pretty much any anti-TB medication they could throw at it (12 first and second line TB drugs in all).1 Theo Smart http://www.aidsmap.com///page/2255720/ Two must-read studies published this month reinforce the case for cotrimoxazole prophylaxis in people living with HIV in low and middle-income settings. Keith Alcorn http://www.aidsmap.com///page/2252396/ The deadline for abstract submissions to the 19th International AIDS Conference (AIDS 2012) is fast approaching. The deadline is February 15th 2012. Keith Alcorn http://www.aidsmap.com///page/2232605/ The current HATIP article is the first in a two-part series on developing lab capacity - to support more active TB case finding. Active case finding is important to more quickly identify and diagnose cases of TB that might not otherwise have been diagnosed, and reduce the opportunity for these cases to spread TB in the communities. Theo Smart http://www.aidsmap.com///page/2221186/ REMEMBER stands for 'Reducing Early Mortality and Early Morbidity by Empiric Tuberculosis (TB) Treatment Regimens' and is a randomised controlled trial that is currently enrolling at the international ACTG sites in a number of resource-limited countries. Theo Smart http://www.aidsmap.com///page/2214676/ One of the recent editions of HATIP published in November 2011 addressed the extent to antiretroviral therapy (ART) could be used to reduce the burden of TB. There is no doubt that after the first few months of treatment ART dramatically decreases the risk of active TB in people living with advanced HIV disease - the question is how much of an effect it has on the risk of TB in HIV-positive people with higher CD4 cell counts. Theo Smart http://www.aidsmap.com///page/2212436/ "A nurse can initiate antiretroviral therapy (ART) and treat children with HIV, a common, manageable paediatric condition," said Sister Martha Mashele, who shared how she overcame her fears and empowered herself to initiate ART and thus, save the lives of children with HIV, before a crowd of doctors, nurses, pharmacists and counsellors gathered at the Paediatric AIDS Treatment for Africa Forum held in Gaborone, Botswana in November 2011. Theo Smart http://www.aidsmap.com///page/2204257/ "Our conferences are very different to any other, our PATA Forums," said Dr Paul Cromhout of the Small Projects Foundation (which works in community development in the Eastern Cape of South Africa), but who also serves on the steering committee of Paediatric AIDS Treatment in Africa (PATA), sometimes called Team PATA. Theo Smart http://www.aidsmap.com///page/2157066/ It can be a very powerful tool for advocacy when people living with HIV can document human rights violations that they experience in their own communities - particularly when they don't shy away from what some may see as sensitive topics, like the experiences of HIV-positive men who have sex with men, according to Calorine Kenkem of Le Réseau Camerounais des Associations de Personnes Vivants avec le VIH (the Cameroonian Network of Associations of People Living with HIV) or RéCAP+. She was speaking at the 3rd HIV Leadership through Accountability (LTA) Planning and Review Meeting, held this July in Nairobi, Kenya. Theo Smart http://www.aidsmap.com///page/2133637/ As noted elsewhere on aidsmap, Winstone Zulu, the first Zambian to come out publicly about his HIV-positive status (in 1990) who later went on to become one of the very first TB-HIV activists, has passed away.  We thought there was some more to add about the contribution that he made to activism, in both his own and his colleagues words. Anon http://www.aidsmap.com///page/2107700/ Sexual and reproductive health rights for people living with HIV have begun to receive greater recognition in the past few years, as a result of advocacy by people living with HIV. Theo Smart http://www.aidsmap.com///page/2087258/ "Positive Health Dignity and Prevention (PHDP) is an empowering concept that has managed to bring together the diverse networks of people living with HIV (PLHIV) in Tanzania to work towards one important goal that we are passionate about," said Sammy Musunga, of the National Council for People Living with HIV and AIDS (NACOPHA). Speaking at a board meeting of the Global Network of People Living with HIV/AIDS (GNP+), held in Cape Town early in April, Musunga described some of the challenges and successes introducing Positive Health Dignity and Prevention (PHDP), a new HIV prevention framework developed by people living with HIV, into his country. Anon http://www.aidsmap.com///page/1793648/ NEPHAK's experience with the HIV Leadership through Accountability Programme Theo Smart http://www.aidsmap.com///page/1772528/ "If anybody here, or anywhere else today, believes we are over-exaggerating the problems of HIV/AIDS and TB, they are living in a fool's paradise," said Dr Aaron Motsoaledi, South Africa's progressive Minister of Health last week at an event commemorating World TB Day. "HIV/AIDS and TB together constitute the worst public health care crisis this country has ever been faced with." Theo Smart http://www.aidsmap.com///page/1746797/ Theo Smart http://www.aidsmap.com///page/1746803/ For a number of journalists (myself included), World TB Day marked the third consecutive day of a media tour providing mostly local press with the background on the TB and drug-resistant TB epidemic to highlight DOH's efforts where it is most needed - particularly in the province of KwaZulu Natal (KZN). Theo Smart http://www.aidsmap.com///page/1746807/ Theo Smart http://www.aidsmap.com///page/1746854/ Full details of the study which contributed to the development of new WHO guidance on intensified case finding for tuberculosis in people with HIV infection have now been published in PLoS Medicine, and the full text is freely available. Anon http://www.aidsmap.com///page/1615495/ "If you look at the figures, the big problem is there just isn't enough money for healthcare in Sub-Saharan Africa. And if you look at population versus burden of disease and then look at total health expenditure, there is something fundamentally wrong," said Dr Joep Lange, Founder and Chairman of the PharmAccess Foundation. Anon http://www.aidsmap.com///page/1530833/ The staged introduction of new TB drug sensitivity testing technologies to improve MDR-TB case detection in Khayelitsha Anon http://www.aidsmap.com///page/1523900/ I am in the process of pulling together an article about family-centred care as a means to improve the treatment outcomes of HIV-infected children. Carole Leach-Lemens http://www.aidsmap.com///page/1513234/ "I have been working with opioid substitution therapy (OST) programmes for the last 4 years and I can tell you, honestly, that sometimes I am tired of it. Sometimes I feel so fed up with all of these clients and I feel like quitting because it really is difficult," Dr Illia Podolyan, chief narcologist of the Odessa Regional Narcological Dispensary, told me last October when I was on a trip in Ukraine to see how that country was, haltingly, rolling out integrated TB/HIV and OST care for people who inject drugs (PWID). Anon http://www.aidsmap.com///page/1512679/ This post is just a brief update to report on another case where a TB patient was incarcerated and to relate an important comment in response to a query from a previous HATIP article. Anon http://www.aidsmap.com///page/1511426/ About two weeks ago, the Associated Press ran a story reporting that two men had been sentenced to Kapsabet prison in western Kenya for 8 months. Their crime? Not adhering to their TB regimen. Theo Smart http://www.aidsmap.com///page/1506861/ This is the first post to the new HATIP blog, a forum where we hope to discuss some of the implications of new research, guidelines and news on the practice of delivering care for HIV, TB and other health services in resource-constrained settings - as well as discuss some of the topics we are currently working on. Theo Smart http://www.aidsmap.com///page/1509310/