title: TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo.
abstract: BACKGROUND
  HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo.
  
  
  METHODS
  A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics.
  
  
  RESULTS
  Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases' control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes.
  
  
  CONCLUSIONS
  HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region.
authors.affiliation: School of Health and Medical Sciences, Örebro University, Örebro, Sweden ; Division of Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Berthollet Bwira
authors.initials: BB
authors.lastname: Kaboru
authors.affiliation: Division of Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Brenda A
authors.initials: BA
authors.lastname: Ogwang
authors.affiliation: Faculté des Sciences de Santé et Developpement Communautaires, Université Libre des Pays des Grands Lacs, Goma, Democratic Republic of Congo.
authors.forename: Edmond Ntabe
authors.initials: EN
authors.lastname: Namegabe
authors.affiliation: Faculté des Sciences de Santé et Developpement Communautaires, Université Libre des Pays des Grands Lacs, Goma, Democratic Republic of Congo.
authors.forename: Ndemo
authors.initials: N
authors.lastname: Mbasa
authors.affiliation: Inspection Provinciale de la Santé, Goma, Democratic Republic of Congo.
authors.forename: Deka Kambale
authors.initials: DK
authors.lastname: Kabunga
authors.affiliation: Faculté des Sciences de Santé et Developpement Communautaires, Université Libre des Pays des Grands Lacs, Goma, Democratic Republic of Congo.
authors.forename: Kambale
authors.initials: K
authors.lastname: Karafuli
keywords: Co-Infection; Congo; Disease Control; HIV; Integrated Services; TB