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CUAMM Factsheet GILEAD Tanzania Factsheets Final TEST & TREAT IN TANZANIA FIGHTING HIV Project area those whose CD4 blood count is below 350 cells/mm3 receive antiretroviral (ARV) therapy; if their CD4 count is Old Maswa (Bariadi Town Council) between 350 and 500 cells/mm3, patients do not receive Regional Hospital (Shinyanga Municipal) Songambele immediate treatment. With the T&T approach (Fig. 1), (Nkololo, Bariadi District) all patients who are diagnosed with HIV can receive Ngokolo Mwamapalala antiretroviral treatment. (Shinyanga Municipal) (Itilima District) Mwanza Bugisi Bariadi (Shinyanga District) Simiyu Bokoba 1 diagnosis 1 treatment Shinyanga Bariadi Mwanza Itilima Bariadi Maswa Shinyanga Shinyanga DC Simiyu Shinyanga Shinyanga TO HALT Dodoma Morogoro Kilosa DC Tosamaganga Mikumi Dar es Salaam Iringa spread of the Iringa Iringa DC Mufindi DC disease in the the course Morogoro delays in Njombe Njombe treatment population of the disease Songea Ruvuma Figure 1: The T&T Approach To increase the number of people tested and treated for HIV, CUAMM implemented a strategy that involves HIV; testing; treatment; Keywords: hospitals, health centers (HUBs) and local communities community; CLUB (CLUBS) in a continuum of care (Fig. 2). The creation of CLUBs aims to decentralize HIV services from hospitals to primary care facilities and to shift tasks from doctors HIV IN TANZANIA to nurses and community health workers. Moving away In Tanzania, the fi rst HIV/AIDS cases were detected from health facilities to a community-based model, in the early 1980s and nowadays it is still a major public makes it easier to reach and manage patients that live in health challenge (Table n.1)1. peripheral and more isolated areas. When a HIV+ patient is stable (according to specifi c requirements) s/he can voluntary decide to join a community CLUB closer to his/ Adults and children living with HIV 1.700.000 her household and receive education and drugs from a Adults aged 15 and over living with HIV 1.600.000 community health worker. After having established 6 HUBs and 71 CLUBs, the Children aged 0 to 14 living with HIV 93.000 project focused on organizing specifi c index testing and People living with HIV who know their status 1.400.000 supporting people and households most at risk of HIV, in Adults and children newly infected with HIV 77.000 order to test them and, if positive, enrolled them into the CLUBs and HUBs model, to ensure they receive quality People living with HIV who are on ART 1.300.000 treatment and counselling. Table n. 1: HIV in Tanzania 2019 Project Strategy CUAMM’S INTERVENTION: COMMUNITY CLUBs TEST&TREAT APPROACH IN COMMUNITY COMMUNITY SENSITIZATION BASED ART SHINYANGA AND SIMIYU REGION AND TESTING DELIVERY CUAMM fi str encountered the HIV virus in 1984 at MODEL REFERRAL LINKAGE LTFU Bukoba Regional Hospital in the region of Kagera. TRACING Today, still committed to end the epidemic, CUAMM has TEST TREAT implemented a dedicated 5 years project in the regions IMPROVING CLINICAL, DIAGNOSTIC AND of Shinyanga (HIV prevalence 5.9%) and Simiyu (HIV TESTING SERVICES prevalence 3.9%) to provide free care and treatment for HIV, introducing the Test&Treat (T&T) approach, as COLLABORATION WITH LOCAL suggested by WHO guidelines. AUTHORITIES The previous approach to tackle HIV did not guarantee AND NGOs HUBs immediate treatment for HIV-infected patients: only Figure 2: The Project Strategy 1 UNAIDS, Country: United Republic of Tanzania, 2019. [online] available at: https://www.unaids.org/en/regionscountries/countries/ unitedrepublicoftanzania [Accessed 14/12/2020] MAIN RESULTS 2017-2020: NUMBER OF TESTS PERFORMED BY LOCATION Since May 2017 to September 2020, 293,539 people have been tested. 500,000 450,000 400,000 350,000 Final project target 300,000 19,713 250,000 66,345 200,000 Special events 150,000 HUBs 100,000 207,481 50,000 Testing Campaigns 0 Triage at a Test&Treat point in Bugisi TOTAL NUMBER OF CLIENTS RECEIVING ANTIRETROVIRAL TREATMENT (ART) BY HUBS Since January 2017 to September 2020, 7,426 people have been enrolled into ART. 3,500 3,000 2,500 2,000 1,500 1,000 500 0 17 17 17 un un 18 un 19 un 20 -J -J -J -J Jul-Sep Jul-Sep 18 Jul-Sep 19 Apr Apr Apr Jul-Sep 20 Oct-Dec 17 Jan-Mar Oct-Dec 18 Oct-Dec 19 Apr Jan-Mar 18 Jan-Mar 19 Jan-Mar 20 Bugisi Ngokolo Mwamapalala Songambele RRH Shy Old Maswa CLUB DATA (SEPT 2020) Ngokolo Bugisi Shy RRH Mwamapalala TOTAL Number of health workers recruited to implement the CLUBs model 2 4 2 2 10 Number of CLUBs established and functional 14 33 14 10 71 Number of HIV+ clients enrolled in the CLUB 196 659 243 180 1,278 Number of HIV+ clients enrolled in the CLUBs who were definitive 20 62 5 21 108 referred back to the CTC Number of HIV+ clients enrolled in the CLUBS who are lost to follow up 4 5 0 2 11 COVID-19 PREPAREDNESS AND RESPONSE: In response to Covid-19 pandemic, the following activities have been implemented: • Virtual trainings on Case Management and IPC; • Covid-19, PPE usage and triage training for health workers in health facilities; • PPE distribution; • Community awareness and sensitization activities..
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