Integration of HIV services into the National Tuberculosis Program of Cameroon: the experience of the Littoral Province

ObjectiveTo evaluate the implementation of collaborative HIV/TB activities recommended by the World Health Organization in the Littoral Province of Cameroon from 2007 to 2009.MethodsData from the tuberculosis (TB) and HIV registers of 30 health facilities (basic management units for TB) from 2007 to 2009 were analysed. During this time period, standard operating procedures for antituberculous therapy, HIV testing of TB patients, and cotrimoxazole prophylaxis for HIV positive TB patients, had been introduced and monitored. Measures had been taken to ensure the continuous availability of HIV test reagents and cotrimoxazole, and charges for HIV tests and cotrimoxazole had been abolished.ResultsThe HIV testing rate rose from 55.0% in 2007 to 91.7% in 2009 (P < 0.000 1). The cotrimoxazole prescribing rate in TB/HIV co-infected patients increased from 76.1% in 2008 to 93.5% in 2009 (P < 0.000 1). The mortality of newly-recruited TB patients fell from 7.2% in 2007 to 3.1% in 2009 (P < 0.000 1).ConclusionsA structured approach towards integration of HIV and TB services effectively improves HIV case detection and cotrimoxazole prescription among TB/HIV co-infected patients in Cameroon. This approach can achieve a significant reduction of the mortality in this patient group.