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
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
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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