WHO recommended collaborative TB/HIV activities: evaluation of implementation and performance in a rural district hospital in Cameroon

BACKGROUND: The objective of the study was to assess the implementation and the performance of recommended collaborative TB/HIV activities in Batibo District Hospital (BDH) and to determine the prevalence of HIV in TB patients in this rural locality. METHODS: The implementation of collaborative TB/HIV activities was assessed through interviews with health workers in the hospital. The implementation score was calculated as the proportion of recommended activities effectively implemented in the hospital. The performance of implemented activities and the prevalence of HIV were determined through review in HIV and TB registers of routine data for the period 2003-2008. RESULTS: The implementation of collaborative TB/HIV activities though triggered by the existence of both TB and HIV units in the hospital was only moderate with an implementation score of 50%. All implemented activities aimed at reducing the burden of HIV in TB patients. The performance of implemented activities was in average 61% (n=179) and 82% (n=77) respectively regarding HIV testing among TB patients and antiretroviral therapy coverage in TB/HIV co-infected patients. Provision of isoniazid preventive therapy (IPT) was inexistent in this hospital due mainly to the lack of tuberculin skin test and isoniazid tablets. The prevalence of HIV among TB patients in this rural locality was 53%. This prevalence was 55% in females and 44% in males (p=0.19). CONCLUSION: The implementation of collaborative TB/HIV activities in BDH was effective only regarding activities to reduce the burden of HIV among TB patients. There is urgent need to strengthen the capacity of this rural health facility in providing IPT services.