|Finalized TB/HIV Guidelines for the Caribbean|
The much anticipated “Caribbean Guidelines for the Prevention, Treatment, Care and Control of Tuberculosis and TB/HIV” is now available. These revised guidelines are a result of collaboration between Caribbean Epidemiology Centre (CAREC), Caribbean HIV/AIDS Regional Training (CHART) Network, International Training and Education Center for Health (I-TECH), Francis J. Curry Tuberculosis Center (CNTC) and Pan American Health Organization HIV Caribbean Office (PHCO). Funding for this initiative was provided by the U. S. Agency for International Development (USAID) and the U.S. Health Resources and Services Administration (HRSA).
The Network collaborated with the Francis J. Curry National Tuberculosis Center (CNTC) and I-TECH to provide training to clinicians involved in patient treatment and care of Tuberculosis and TB/HIV co-infection.
Four major accomplishments have been achieved from the collaboration:
Caribbean Regional TB Guidelines (CTBG) have been updated to incorporate the International Standards for Tuberculosis Care and to highlight areas where TB and HIV/AIDS programme collaboration could improve patient diagnosis, treatment, and clinical management. Important updates to the guidelines include the addition of a laboratory component and modifications to specific TB treatment regimen recommendations in response to anticipated new recommendations underway from the World Health Organisation (WHO). Thirteen associated job aides and 16 training modules were also developed to accompany the CTBG.
TB Clinical Consultation service, with the agreement of some of the specialist clinicians from participating countries, a telephone “warm line” has been created and operated from the CNTC to allow discussion about complex TB cases, such as cases of multi-drug-resistant TB. Participants are in-country physicians or Chief Medical Officers who serves as consultants for their respective National TB Programmes. The process is for any doctor, nurse, or other clinician to seek out the identified in-country expert for TB related clinical or programmatic questions. Each expert then consults with the CNTC as needed, for more complex questions related to the care and treatment of persons living with TB.
Three countries were identified to roll out this programme: St. Lucia, Suriname, and Trinidad & Tobago with six additional countries participating in the consultation service as of October 2009: Antigua & Barbuda, Barbados, Dominica, Grenada, St. Kitts and Nevis and St. Vincent and the Grenadines.
A Training of Trainers workshop (TOT) was conducted in June 2009 using the revised guidelines to train physicians and nurses with technical expertise in TB to allow them to gain proficiency in training others. A total of 23 participants from thirteen Caribbean countries participated in this training. Each country developed action plans that outlined TB and TB/HIV co-infection activities to be accomplished in their respective countries. The action plans are to be shared with the Permanent Secretaries of Ministries of Health and other leaders in the health sector to obtain their ratification and support.
A Network of Caribbean Nurses in TB Care was formed to provide a forum through which nurses caring for patients with TB and TB/HIV in the Caribbean can share their case management experiences, challenges and strategies. This Network of Caribbean Nurses in TB Care includes participants from: Antigua & Barbuda, Barbados, the Bahamas, Dominica, Grenada, St. Lucia, St. Kitts and Nevis, St. Vincent and the Grenadines, Suriname and Trinidad and Tobago. Through this Network nurses will be able to share resources including information for educating patients, tools to aid in the management of TB and TB/HIV patients, and case presentations. Conference calls coordinated by the CHART RCU and facilitated by the TB experts from the Francis J. Curry National TB Center are held with participating nurses on regular intervals. The nurses within the Network also agreed to communicate with each other via email for ongoing and ad hoc support.