title: Scale-up of TB and HIV programme collaborative activities in Zambia - a 10-year review.
abstract: OBJECTIVE
  To review the activities, progress, achievements and challenges of the Zambia Ministry of Health tuberculosis (TB)/HIV collaborative activities over the past decade.
  
  
  METHODS
  Analysis of Zambia Ministry of Health National TB and HIV programme documents and external independent programme review reports pertaining to 2000-2010.
  
  
  RESULTS
  The number of people testing for HIV increased from 37 557 persons in 2003 to 1 327 995 persons in 2010 nationally. Those receiving anti-retroviral therapy (ART) increased from 143 in 2003 to 344 304 in 2010. The national HIV prevalence estimates declined from 14.3% in 2001 to 13.5% in 2009. The proportion of TB patients being tested for HIV increased from 22.6% in 2006 to 84% in 2010 and approximately 70% were HIV positive. The proportion of the HIV-infected TB patients who: (i) started on ART increased from 38% in 2006 to 50% in 2010; (ii) commenced co-trimoxazole preventive therapy (CPT) increased from 31% in 2006 to 70% in 2010; and (iii) were successfully treated increased to an average of 80% resulting in decline of deaths from 13% in 2006 to 9% in 2010.
  
  
  CONCLUSIONS
  The scale-up of TB/HIV collaborative programme activities in Zambia has steadily increased over the past decade resulting in increased testing for TB and HIV, and anti-retroviral (ARV) rollout with improved treatment outcomes among TB patients co-infected with HIV. Getting service delivery points to adhere to WHO guidelines for collaborative TB/HIV activities remains problematic, especially those meant to reduce the burden of TB in people living with HIV/AIDS (PLWHA).
authors.affiliation: Ministry of Health, Lusaka, Zambia. nkapata@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Kapata
authors.forename: P
authors.initials: P
authors.lastname: Chanda-Kapata
authors.forename: M P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: J
authors.initials: J
authors.lastname: O'Grady
authors.forename: S
authors.initials: S
authors.lastname: Schwank
authors.forename: M
authors.initials: M
authors.lastname: Bates
authors.forename: S
authors.initials: S
authors.lastname: Jansenn
authors.forename: A
authors.initials: A
authors.lastname: Mwinga
authors.forename: F
authors.initials: F
authors.lastname: Cobelens
authors.forename: P
authors.initials: P
authors.lastname: Mwaba
authors.forename: A
authors.initials: A
authors.lastname: Zumla
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D000995:Antitubercular Agents / Q000627:therapeutic use; D003299:Cooperative Behavior; D005260:Female; D005500:Follow-Up Studies; D006078:Government Programs / Q000458:organization & administration*; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D015397:Program Evaluation; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control*; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D000890:Anti-Infective Agents; D000995:Antitubercular Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination