1. Situational Analysis for Implementing TB/HIV Surveillance in COTE D’IVOIRE
Dr AKAKI Angennes; Dr SAN Koffi / NTCP
Dr EBAH Laurence; Dr TANOH Antony /ACP

2. TB Epidemiology Estimated Incidence:
cases/100,000;
new SSC+ /100,000 in 2003
Proportion of TB patients co-infected with HIV: 46% in 2002
DOTS: yes
Percent DOTS coverage: 74% of pop
Electronic TB reporting system: ongoing
TB data aggregated at District level were sent and compiled at national level
A new electronic TB reporting system is tested now in one TB diagnosis center in Abidjan.

3. HIV Epidemiology
Estimated prevalence of HIV in general population: 9.7% in 2002
Estimated prevalence of HIV among at-risk population groups
Female sex workers: 33% in 2003
HIV prevalence setting: Generalized and stable for 3 years
Sources of HIV prevalence data: antenatal
Electronic HIV Reporting System: Yes
since the launching of the drug access initiative in 1998, the national data base is located at CDC-RETRO-CI office
Could TB and HIV systems be linked? Yes

4. Diagnosis and Treatment (1)
Current lab capacity:
74 TB diagnostic centers (56 functional in 2003)
6 main regional TB clinics
50 TB diagnosis and treatment center
12 VCT centers ( 7 integrated )
Current situation for HIV testing of TB patients:
Routine HIV VCT services offered in 8 main TB clinics from 1994 through 2002 (In collaboration with CDC/Retro-CI)
A devolution process of CDC/Retro-CI lab activities is on ongoing
Since 2003: 2 TB diagnosis center offer HIV VCT services ( Abidjan and Daloa )

5. Diagnosis and Treatment (2)
Current situation for TB screening/referral of PLWHA?
All PLWHA are screened for TB (clinical, X-ray) in HIV treatment centers
All TB suspect patients are systematically referred to TB diagnosis centers
Current Treatment of PLWHA with ARVs, in particular TB Patients?
HIV positive patients eligible for ARV therapy: 126,000 (estimated number)
HIV positive patients currently receiving ARV therapy: 3,000 ( September 04)
TB/HIV positive patients receiving ARV therapy: not available

6. Human Resources and Surveillance for TB, HIV (1)
How is surveillance conducted for HIV in TB patients, if applicable?
Routine HIV VCT services are offered in 8 main TB centers
Current human resources for HIV surveillance, TB surveillance, and TB/HIV surveillance
Health staff in the ANC and TB clinics with the support of CDC/Retro-CI

7. Future human resource and surveillance needs for TB, HIV
Health Level
Needs
Health facilities
Districts
Nurses
65 Data managers
Regional level
19 Data managers
Central Level
(HMIS, NTP, HIV program)
Data Manager, epi-stat,

8. Other Considerations for Implementing TB/HIV Surveillance
Potential alternative surveillance approaches
Periodical survey to estimate the prevalence of TB among PLWHA
Potential Obstacles
Financial resources
Methodology/Feasibility
Human Resource requirements
According to the survey design