Saturday, September 26, 2009

Strengthening Public Health Systems and Services -

Care and treatment initiatives provide hope to adults and children living with HIV/AIDS through the provision of services that support quality of life, including life-saving antiretroviral therapy (ART).
Through the President's Emergency Plan for AIDS Relief (PEPFAR), and in collaboration with U.S. government partners, host governments, ministries of health, non-governmental organizations, international organizations, U.S.-based universities, and the private sector, CDC:Builds Capacity for HIV Care and Treatment
Assists countries to plan, implement, and evaluate effective strategies for HIV care and treatment.
Provides HIV care and treatment expertise to partners on management, standard operating procedures, human resources, physical infrastructure, training, laboratory services, monitoring and evaluation, community services, linkage with HIV and other programs, promotion of prevention, and sustainability.
Develops, disseminates, and provides training on global palliative care and ART tools, guidelines, and policies.
Bolsters Prevention of Mother-to-Child Transmission Programs and Pediatric Services
Provides technical assistance for scale-up of prevention of mother-to- child transmission (PMTCT) and pediatric activities and linking PMTCT and pediatric HIV programs with other services.
Contributes to the scientific body of knowledge on global PMTCT and pediatrics and develop and disseminate tools, guidelines, and policies to translate research for improved program implementation in resource-constrained countries.
Conducts public health evaluations to promote best practices, address barriers, and respond to emerging scientific issues for PMTCT and pediatric HIV service delivery.
Strengthens TB/HIV Programs
Provides technical assistance for scale-up of TB/HIV activities, including HIV testing and counseling, referral, and care and treatment among TB patients.
Helps countries develop national and regional guidelines for HIV-related TB diagnosis, treatment and prevention.
Strengthens awareness and implementation of basic TB infection control in HIV care and treatment settings.
Haiti, Trinidad and Tobago, and 13 African CountriesEarly Infant Diagnosis: Left unidentified and untreated, studies show that 50-60% of HIV-infected infants die by age two. Early Infant Diagnosis (EID) by dried blood spot (DBS) gives HIV-infected infants early access to appropriate care and treatment. With the simple prick of an infant’s heel, toe, or finger, whole blood is placed onto a card to dry, creating samples which are stable for relatively long periods without refrigeration, and are light and simple to transport. CDC has worked with partners to implement and expand EID services in 15 countries.
UgandaBasic Care Package: CDC led operational research conducted in rural Uganda and elsewhere that integrates a package of interventions (Basic Care Package) to minimize the susceptibility of HIV persons to common opportunistic infections and unsanitary water. This research demonstrated that this integrated package can help reduce deaths, hospital visits, and illnesses, including malaria and diarrhea, among HIV-positive people and their families. The Basic Care Package is a low-cost, evidence-based way to promote health and reduce HIV/AIDS infections. The package includes insecticide-treated mosquito nets; water vessel, filter cloth, and bleach solution to disinfect water; information on how to obtain HIV family counseling, HIV testing services; and cotrimoxazole -- an antibiotic that reduces opportunistic infections among HIV positive persons. After six months of implementing the Basic Care program in Uganda, CDC found that over 90 percent of recipients used cotrimoxazole prophylaxis every day and over 60 percent of the respondents used the water vessel. CDC is also now providing Basic Care Packages in other countries in the region.
ThailandPediatric HIV Treatment: CDC helped develop teams of physicians, nurses, counselors, pharmacists, and persons living with HIV/AIDS (PLWHA) in 12 community hospitals in Thailand’s Chiang Rai province. For the few pediatricians skilled in providing antiretroviral therapy (ART), the multidisciplinary approach is a way to extend their reach and reduce their workload. Although almost all HIV-infected children in Thailand can receive treatment through the national ART program, care networks face challenges such as pain management, stigma, and poor transportation systems marked by winding mountain roads. But thanks to the collaboration between specialists and the local community, these problems are being addressed. The comprehensive team approach and two inexpensive plastic devices that help children stick with ART -- wrist watches that beep every 12 hours, and 7-day pillboxes -- are resulting in high adherence rates. The rate-more than 95 percent in most patients -- is better than that found in most developed countries.
Botswana, Ethiopia, Kenya, Rwanda, Tanzania and ThailandTuberculosis (TB) is the leading cause of death among HIV-infected individuals, and one of the most common opportunistic infections. The prevalence of HIV infection among patients in TB clinical settings is high-- up to 80 percent in some countries. In many countries, including Botswana, Ethiopia, Kenya, Rwanda, Tanzania, and Thailand CDC has worked with partners to support the expansion of provider-initiated testing and counseling among TB patients, and collaborated with international partners to develop and disseminate protocols, training and policy to improve the integration of HIV and TB service care.



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