TB and TB-HIV in the
Area Surrounding St. Philip’s MissionMhlathuzeLubombo
A ministry of the Missionary Sisters of the Sacred Heart
St. Philip’s Mission, Mhlathuze
Who is Cabrini Ministries?Catholic Faith Based Organization working in area
surrounding St. Philip’s since 1971
Changing services as needs have changed
Presently seeking to respond to the needs generated by the HIV-TB pandemic surrounding St. Philip’sHealthcare exclusively for HIV/AIDS and TB patientsChildcare – for orphans and vulnerable children
Who is Cabrini Ministries?Active Partner in the Swaziland Stop TB
Partnership
Strong collaborators with the National TB Program
Partner in various other national response co-operations including:HIV/AIDS ConsortiumNCCUPartnerships with other NGOs to provide
comprehensive services
Current situation in areaFamilies overburdened Food insecurityExtreme UnemploymentLack of financial meansLack of electricityPoor roadsUnregulated costly transportLack of clean water / Lack of
waterLack of SanitationMajority of clients do not read or
write and have never left the area
Health issues in area • HIV and AIDS• TB
Health issues in area • Lack of access to
health services• Lack of follow-up• Malnutrition• Strong hold of
traditional healing, fear of other healing, fear of leaving area for treatment.
SERVICES PROVIDED TO:Anyone who wants to test
for HIV or TB in the service area
All those who are HIV or TB positive in the service area
HTC, including partial service with referral to local clinics for those outside of Cabrini service area
Presently actively serving over 2,000 HIV, AIDS, TB clients; number served increases by about 1% per month.
CM HealthcareCabrini commenced as a TB diagnostic
centre in 2010So far we have initiated 121 patients on TB
treatment73% of all TB patients are co-infected with HIV25% of all TB patients are MDR casesProvide a continuum of health care services for
HIV, AIDS, & TB patients at their homesteadsProvide access to healthcare, clinical
management and support services and ongoing community education
CM HealthcareHealth Care
Outreach for HIV, AIDS and TB - Access to Care for rural people
At Cabrini Ministries, TB care is fully integrated into HIV care
Case finding – hard, labour intensive, but possible if there is the WILL to do it.
Current healthcare services offered
HIV, AIDS, TB Education: prevention, adherence
HIV testing and counsellingTB sputum testing for every HIV+
client with TB symptomsART pre-counselling and adherence
counselling with individuals and groups; on homesteads
ART outreach centre of Sithobela HC
Current healthcare services offered
TB teaching and TB adherence teaching in the community; on homesteads
Nutrition support weekly Transport to hospital (including
chemotherapy)Home Visits daily to follow-up the very
sick, dying, defaulters PMTCT with St. Philip’s ClinicDay and overnight care as necessary at
drop-in Center
TB outreachTB fully integrated into all HIV servicesTB screening of all HIV tested and HIV positive
peopleOngoing TB screening of HIV patients on
treatment when they come in for refillsTB treatment initiation of all sputum positive
patientsVisit to patients within two weeks of TB treatment
initiation to assess progress and encourage treatment compliance
For all HIV+ TB patients the patient is prepared and initiated on HAART
TB outreachFood parcels are given to those in needDefaulters followed up through phone
calls and/or homestead visits.Provide tents where necessary to assist
with isolation of TB patients on homesteads
Transport provided to MDR patients to Moneni
Community LinkagesSince February, collaboration with 2
Government clinics (1 day per week each)SiphofaneniSinceni
to assist with HIV & TB treatment defaultersCM doctor present 1 day at each clinic for
initiation of TB and ART medication
SuccessesLess than 3% default rate for TB
treatmentAble to integrate TB and HIV
treatment activitiesLess than 1% default rate for HIV+
patients
ChallengesPatients coming very late for
treatmentReluctance by clients to start
HAART 2 weeks post TB initiationFood shortages negatively impacting
treatment compliancePill burden
SIYABONGA KA KHULU