This presentation describes the presenter's experience of planning integrated HIV/tuberculosis services at the Good Shepherd Hospital, Lubombo Region, Swaziland. In contrast to the very unsatisfactory situation before the project, a new facility has been built that separates TB and HIV patients, and the hospital now tests every HIV positive person for TB and vice versa. This has allowed more infected patients to be identified and registered, supervised and treated. Patients who are at risk of defaulting on their treatment are visited at home by adherence officers. It has been found that most patients can be more effectively cared for at their local health centres than in a hospital. Family members and volunteers also have an important role providing support to TB patients to ensure that they continue with their treatment. It is planned to replicate this successful project elsewhere in Swaziland.
Presentation to a panel of TB and HIV experts, London, UK, October 2009.