HIV disease in BULAWAYO Photo: WHO 2007 Dr. Paco Trinchán Medical Officer BCC August 2013.

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Presentation transcript:

HIV disease in BULAWAYO Photo: WHO 2007 Dr. Paco Trinchán Medical Officer BCC August 2013

ZIMBABWE POPULATION: 12,619,600 (July 2012)

HIV / AIDS

HIV adults prevalence Prevalence of HIV – 15% (Dec 2012)

HIV and AIDS in Zimbabwe December 2012_ NAC Estimated number of people living with HIV – 1,242,768 Prevalence of HIV – 15% (in BYO 18 %) Estimated number of new infections – Estimated annual HIV deaths – Number of adults in need of ART – (CD4 < 350) Number of adults on ART: Adult ART coverage – 86 % ( / ) Children ART coverage – 41% (39825 children, Dec 2011 est.) Estimated AIDS Orphans – (25% of all ZW children) Life expectancy at birth: 52 years (2012), declining from 62 years in 1990

BULAWAYO

Bulawayo Public Health System Bulawayo: people 2 regional Hospitals (MoH): Mpilo Htal UBH Htal 1 Psychiatric hospital (Ingutsheni Htal) MoH 19 BCC city clinics 1 infectious diseases hospital (TB) Thorngrove Htal

August 2013

ART in BYO BCC Mpilo Htal UBH Htal Ingutsheni Htal CITY TOTAL ADULTS on ART CHILDREN on ART460 ? ?

TUBERCULOSIS

TUBERCULOSIS Notification rate of TB cases in Zimbabwe: 603/ population (2011 est.) Bulawayo notified 2797 cases of TB in 2012 ( 500 cases in 1985!!) TB / HIV co-infection rate: 79.5 % (2012)

Many Challenges ! Some of them (in BYO):

Challenges – HIV programme (1) Staff shortage: Clinics have only 60 % of nurses Only 4 doctors visiting BCC clinics The challenge of running multiple programmes at the same time: HIV/TB, non-communicable diseases, EPI, IMCI…, with few staff !! Therefore, the challenge of quality follow up in a congested OIC without adequate staff

Challenges – HIV programme (2) BUT, there is pressure for an increase of our ARVs cohorts without increasing the staff at the clinics The difficult balance: quantity vs quality ? One solution:  ART decentralization Also:  Empowerment of OIC nurses

Other Challenges – HIV programme Early identification of patients in need of ART (before they get too sick!) The challenge of TB diagnosis, PTB (-) or EPTB Insufficient access to VL test Follow up of patients living across the border (SA, BTW) Data capture and entry: Frequent changes in M & E tools. Too many data to record and follow up. Others…

THANK YOU MERCI