Rwanda leading the way in jointly tackling TB and HIV

L to R): Dr Jorge Sampaio, UN Secretary General's Special Envoy to Stop TB, UNAIDS Executive Director Michel Sidibé and Dr Anita, Asiimwe, Executive Secretary of the National AIDS Control Comission during a visit to the Centre Medical Social de Kiryogo near Kigali, Rwanda on 1 September 2009. Credit: UNAIDS/L.Rusanganw

Dr Jorge Sampaio, the UN Secretary General's

Special Envoy to Stop TB and UNAIDS Executive

Director Michel Sidibé together witnessed,

first-hand, delivery of integrated HIV and

TB services during a visit to

the Socio-Medical Centre in Biryogo.

"It is gratifying to be at this clinic, which has

intensified TB case finding in people living

with HIV through TB screening and transferring

confirmed cases to a TB clinic.

In addition patients who enrol at the health

centre with tuberculosis are also tested for HIV

and those found to be HIV positive are

given integrated care and support.

It is a programme that reflects Rwanda's

impressive progress nationwide on coordinating

TB and HIV services," said Dr Jorge Sampaio,

the UN Secretary-General's Special

Envoy to Stop TB.

Mr Sidibé highlighted the progress Rwanda

has made in improving the outcome of TB

and HIV co-infection through better collaboration

and the use of innovative diagnostic technology

and underlined the UN's commitment

to effectively tackling the dual epidemics.

"I am pleased to see that Rwanda is leading

Africa and the world in taking an integrated

approach to dealing with the interlinked epidemics

of TB and HIV.

Rwanda's bold leadership is achieving

impressive results that show the rest

of Africa what can be achieved," said

UNAIDS Executive

Director Michel Sidibé

Mr Sidibé emphasize that tackling TB

and HIV jointly is a priority for UNAIDS and,

as stated in the UNAIDS Outcome

Framework 2009-2011, it is one of

the nine key areas for achieving results with

the final goal being that no person living

with HIV should die of TB.

Dr Sampaio and Mr Sidibé proceeded

to another joint visit to Rwanda's National

Reference Laboratory in Kigali,

where they saw evidence of the country's

major investment in laboratory services.

Rwanda has been tackling a

thorny issue -- the difficulty of diagnosing TB

among people living with HIV.

TB diagnosis requires visualization under

a microscope of the bacteria that

cause the disease, obtained via

sputum samples.

Among people living with HIV,

often few bacteria are present in

the sputum and they are therefore

not detectable through conventional diagnosis,

even if the person has serious TB disease.

Consequently the diagnosis is often missed.

The sensitivity of a TB diagnosis can be

improved by incubating the samples

to multiply the TB bacteria; but this process

can take weeks or even months

using conventional methods.

To increase speed and accuracy of

TB diagnosis, fast liquid culture (MGIT) will

be introduced and rolled out soon in Rwanda.

The National Reference Laboratory is also

studying more efficient microscopes and

staining techniques to improve

speed of TB diagnosis.

Since 2004 Rwanda has had the capacity

to test for drug-resistant TB.

The National Reference Laboratory and

the other main laboratories in the country

are also currently developing their capacity

to diagnose cases of XDR-TB (although

none have been detected in Rwanda to date).

Dr Sampaio and Mr Sidibé congratulated

the laboratory staff on their excellent work

and recognized the key role they play

in reducing deaths from TB among

people living with HIV.

They highlighted the need for much greater

investment in strengthening laboratory

services and committed to advocating

for increased investment in research

for a faster, simpler and

more accurate TB test.

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