Objectives To describe the development and operation of integrated tuberculosis (TB) and HIV care at the Martin Preuss Centre, a multipartner organization bringing together governmental and non-governmental providers of HIV and TB services in Lilongwe, Malawi.
Methods We used a case study approach to describe the integrated TB/HIV service and to illustrate successes and challenges faced by service providers. We quantified effective TB and HIV integration using indicators defined by the World Health Organization.
Results The custom-designed building facilitates patient flow and infection control, and other important elements include coordinated leadership; joint staff training and meetings; and data systems prompting coordinated care. Some integrated services have worked well from the outset, such as promoting HIV testing among patients with TB (96% of patients with TB had documented HIV status in 2009). Other aspects of integrated care have been more challenging, for example achieving high uptake of antiretroviral therapy among HIV-positive TB patients and combining data from paper and electronic systems. Good TB treatment outcomes (>85% cure or completion) have been achieved among both HIV-positive and HIV-negative individuals.
Conclusions High-quality integrated services for TB and HIV care can be provided in a resource-limited setting. Lessons learned may be valuable for service providers in other settings of high HIV and TB prevalence.
Phiri, S.; Khan, P.; Grant, A.D.; Gareta, D.; Tweya, H.; Kalulu, M.; Chaweza, T.; Mbetewa, L.; Kanyerere, H.; Weigel, R.; Feldacker, C. Integrated tuberculosis and HIV care in a resource-limited setting: experience from the Martin Preuss centre, Malawi. Tropical Medicine and International Health (2011) 16 (11) 1397-1403. [DOI: 10.1111/j.1365-3156.2011.02848.x]