THE UNITED REPUBLIC OF TANZANIA

MINISTRY OF HEALTH

KILIMANJARO INSTITUTE OF HEALTH AND ALLIED SCIENCE

ORDINARY DIPLOMA IN MEDICAL LABORATORY SCIENCES

(NTA LEVEL 6)

A FIELD PROJECT REPORT

ON PREVALENCE OF TUBERCULOSIS IN HIV/AIDS PATIENTS ATTENDED AT

OCEAN ROAD CANCER INSTITUTE (ORCI) FROM, FEBRUARY TO JULY 2023

NAME: ELIHUD K.JULIUS

REGISTRATION NO: NS1801/0047/2011

ACADEMIC YEAR: 2022/2023

SUPERVISOR: MR…………………………….

SUBMISSION DATE: ………………………….

YEAR 2022/2023

i
 EXECUTIVE SUMMARY
Introduction: In areas where tuberculosis is endemic, adult are associated with increased
susceptibility to tuberculosis. It is generally agreed that this risk ends with severely fever,
sweating coughing and later causing death. My study aimed to demonstrate the prevalence of
tuberculosis in HIV/AIDS patient attending at ORCI for diagnosis.

Method of data collection: The data collection method is Retrospective; Data was
collected in laboratory register book and in computer for tuberculosis and the results were
recorded in the collection sheet in which patient’s profile (age, hospital number) and laboratory
results was included from February up to July 2023.

Findings: Statistical data were analyzed using the table, bar chart. Total 178 of HIV/AIDS
patients were enrolled from February to July 2023. In this project study of which 45(25%) were
found recorded to have positive tuberculosis.

Conclusion: My project study shows the number of tuberculosis prevalence among HIV/AIDS
patients at ORCI that is a zonal hospital on the Eastern Tanzania, This small prevalence are
hindered by various biological and environmental condition of Dar es Salaam region that restrain
the mycobacterium tuberculosis from multiplying and become pathogenic. The prevalence of
25% is small and is due to seasonal climatic changes of the region.

Recommendation: The study recommends continuing to improve the quality of care,

tuberculosis prevention and treatment given to HIV/AIDS patients at ORCI, regional hospitals,
district and health centers, also health education on how to prevent and control tuberculosis, also
include the health education and promotion by promoting education to the HIV/AIDS patients on
how to protect themselves from tuberculosis, In order to reach the country’s strategies to
eradicate tuberculosis in endemic areas.

ii
 ACKNOWLEDGMENT

Thanks to the almighty God for standing on my side from the beginning of my work up to this
moment. I am highly indebted to the ORCI for controlling/conducting and managing Health
training in all Health Training center therefore we have benefited a lot.

Firstly, I would like to express my gratitude towards OCEAN ROAD CANCER INSTITUTE
especially the Laboratory manager – Dr. SAUFU MNEMA for material support during the
research work and Quality officer SAMWEL MHINA and all laboratory workers at ORCI
Laboratory for their company and assistance in my Project work.

Secondly, I would like to give special thanks to My Principal of school of medical laboratory at
Kilimanjaro health training institute MR.MKOLA for his assistance in ensuring proper
supervisor, allocation and permission letter to My project field report area and also Academic
master and Examination officer MR. ABDALLAH HHUSEIN and all our medical laboratory
department lectures for their great concern and conscious toward completion of this field work.
They are giving me direction on what supposed to do and correct on what needed in field work.
With respect to that I acknowledge the information offered to me by ORCI. On routine
procedures and investigation of laboratory attending at ORCI laboratory

Thirdly, would like to give the special thanks to our supervisor Mr. ABDALLAH HASSAN for
his instruction and guiding that help me to cover a lot of things about how to develop field work
report.

Fourthly, I would like to express my gratitude towards my parents and other family relatives for
their support in terms of money, kind co-operation and encouragement during challenges in life.

Lastly but not least i have taken efforts in this project. However, it would not have been possible
without the kind support and help of many individuals, colleagues and organizations. I would
like to extend my sincere thanks to all of them.

iii
 LIST OF ABBREVIATIONS
AIDS- Acquired Immunodeficiency Syndrome

BIPAI- Baylor International Pediatric AIDS Initiative

CDC- Center for Disease Control and Prevention

DPAA- Deputy Principal Academic Affairs

GIZ- Gesellschafts fur InternationaleZusammenarbeit.

HIV- Human Immunodeficiency Virus

ICT- Information and Communication Technology

JICA- Japan International Cooperation Agency

KM- Kilometers

NBTS National Blood Transfusion Service

NIMR- National Institute of Medical Research

OBGY- Obstetrics and Gynecology

OPD- PMU- Outpatient Department Project Management Unit

SWOC- Strengths, Weakness, Opportunities and Challenges

TB- Tuberculosis

WHO- World Health Organization

ORCI- . Ocean Road Cancer Institute

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 DECLARATION

I, ELIHUD K.JULIUS declares that this research report is my own original work and that it has
not been presented to any other academic institution for similar or any other diploma award, and
is not previously or currently under copyright.

NAME: SIGNATURE ………………….. DATE …………………………………….

v
 CERTIFICATION

I.................................................... undersigned, certify that this research report is the work of the
candidate carried out under my supervision. I have read and hereby recommend the proposal
entitled: THE PREVALENCE OF TUBERCULOSIS IN HIV PATIENTS ATTENDED AT
OCEAN ROAD CANCER INSTITUTE (ORCI) FROM, FEBRUARY TO JULY 2023. For
partial fulfillment of the Diploma in Health Laboratory sciences.

(Supervisor) MR.............................................

DATE................................................................

vi
TABLE OF CONTENTS
pg
TITLE PAGE ………………………………………………………………………….. i

EXECUTIVE SUMMARY …………………………………………………………… ii

ACKNOWLEDGEMENT ……………………………………………………………. iii

LIST OF ABBREVIATION …………………………………………………………..iv

DECLARATION …………………………………………………………………..... ..v

CERTIFICATION …………………………………………………………………… vi

TABLE OF CONTENT ……………………………………………………………vii-viii

CHAPTER ONE
1.0. INTRODUCTION …………………………………………………………………
1
1.1. Overview of the field work placement ……………………….…………….
1
1.1.1. Geographical, Historical back ground and administrative area of
the field station /owner of ORCI. ………………………………1
1.1.2. Boundaries ……………………………………………………...1
1.1.3. Distance from the city center ………………………………....1-2
1.1.4. Nature of the organization (ORCI) ……………………………. 3
1.2. Primary function and Structure of organization
…………………………....3
1.2.1. ORCI Laboratory Organogram ………………………………...4
1.2.2. Size of the Laboratory facility………………………………… 5
1.2.3. Facility main role ……………………………………………... 5
1.2.4. Staffing position of the health facility (Laboratory)……...…… 6
1.3. Watchment area of the health facility and its population
…………………. 6
1.3.1. The units served by orci hospital ………………………………. 6

CHAPTER TWO
2.0. WORKDONE AND THE LESSON LEARNT ………………………………… 7
2.1. Brief description of task undertaken ……………………………..
…………. 7
2.1.1. Introduction ………………………………………………8
2.2. Problem statement ………………………………………………………….8-9
2.3. Study Objectives………………………………………………………………9
2.3.1. Broad Objective. ……..…………………………………………...9
2.3.2. Specific Objective. ………………………………………………. 9
2.4. Study Questions ………………………………………………………………9
2.5. Significant of the Study. ……………………………………………………...9

vii
CHAPTER THREE
3.0. STUDY METHODOLOGY ……………………………….....…………………….……10
3.1. Overview of the Chapter ……………………………………………………10
3.1.1. Study Area …………………………………………………………….10
3.1.2. Study Design …………………………………………………………..10
3.1.3. Study Population ………………………………………………………10
3.2. Inclusion Criteria …………………………………………………………………. .10
3.3. Exclusion Criteria …………………………………………………………………..10
3.4. Sampling and sample size …………………………………………………………10
3.5. Sampling techniques ………………………………………………………………..10
3.6. Data collection method ……………....………………………………………… 10-11
3.7. Data collection tool …………………………………………………………………11
3.8. Data analysis ………………………………………………………………………..11
3.9. Ethical consideration ……………………………………………………………..…11
3.10. Study limitation ……………………………………………………………...…11
3.11. Dissemination findings ……………………………………………………........11

CHAPTER FOUR
RESULTS/FINDINGD

4.0. Overview of the Chapter ……………………………………………………………12

4.1. Social demographics characteristics ………………………………………...12
4.2. Bar Chart 01: Shows The Prevalence Of Tb In Hiv Patients At Ocean Road
Cancer Institute. …………………………………………………………….13
4.3. Relations of theory learnt in the class to what is happening in the field.
…...13

CHAPTER FIVE
5.0. CONCLUSION AND
RECOMMENDATION……………………………………..14
5.1. Conclusion ………………………………………………………………………….14
5.1.1. Challenges ……….....………………………………………..….14
5.1.2. Recommendation. …………..…………………………………...14
5.2. References …………………………………………………………………………..15

viii
 CHAPTER ONE
1.0. INTRODUCTION
1.1. OVERVIEW OF THE FIELD WORK PLACEMENT

1.1.1. Geographical, Historical back ground and administrative area of the field
station /owner of ORCI.

The Ocean Road Cancer Institute (ORCI) is located along the Indian Ocean about 200 meters
from the beach. This health facility is one of the oldest health institutions in Tanzania having
been founded in 1895 by the German colonial government. At its inception the hospital catered
for German community only. In 1920. After the World War I, the British colonial government
followed the footsteps of their predecessors and continued to provide medical services and
facilities for European communities in this hospital, while Africans had to fend for themselves.

The hospital was inaugurated in October 1895; people were impressed both by its functional
usefulness and aesthetic attraction. The history of the German Government Hospital reflects the
political context of the time as well as the progress of medicine in combating endemic diseases.

While patients were often segregated by race the Ocean Road hospital was almost exclusively
reserved for Europeans, they were all benefitting from the results of medical science taking place
in the hospital. For Robert Koch the hospital (and its laboratory) served as basis for his research
in the field of malaria, tuberculosis, black water fever, sleeping sickness, and relapsing fever. It
was from Africa that he embarked on his journey to Stockholm to receive the Nobel Prize in
December 1905 for his investigations and discoveries in relation to tuberculosis (TB).

During the First World War Ocean Road Hospital, was taken over by the British and it was
catering for the Europeans. After independence in 1961, the Tanzanians took over the hospital
and it was catering for all Tanzanians despite of the race.

After Independence all racial barriers from the colonial past were removed and the Hospital
catered for all races. In the sixties and seventies, the Ocean Road Hospital operated as a
maternity wing of the Muhimbili Medical Centre (MMC). In 1980, a decision was made by the
Ministry of Health to make the Ocean Road Hospital the hub for radiotherapy services for the
Muhimbili medical centre. The government in 1996 through Act number 2 of the parliament
established an autonomous National Cancer Institute called Ocean Road Cancer Institute
(ORCI).

1.1.2. Boundaries

National hospital is located near state hus region along hindi ocean. It is accessible by roads
from different part of daresalaam district such as kinondoni, and temeke, and pwani region as
part of Tanzania. Also in eastern part there is Indian Ocean where there is Island of Pemba,
Unguja and Mafia.

1
 1.1.3. Distance from the city center

The hospital is 2km away from the city center. 3Km away from Morogoro road

Mapping of the field station

2
 1.1.4. Nature of the organization (ORCI)

Ocean Road Cancer Institute (ORCI) is the only comprehensive specialized facility for cancer
care in Tanzania. The Institute was established in June 1996 by an Act number 2 of the
Parliament and is an independent semi-autonomous institute directly under the Ministry of
Health,. Currently, the Institute serves more than 50,000 patients that include about 28,000
cancer patients, 10,000 cancer screening patients, and 12,000 non-cancer patients. In addition,
the Institute attends to over 15,000 clients in the outreach programs in the Tanzania regions.

1.2. Primary function and Structure of organization

The Institute works in partnership with the community to create and maintain an integrated,
accessible, and affordable cancer health care system with quality service to improve health and
well-being of its patients. ORCI offers in patients and outpatients services including laboratory
services, diagnostic imaging, chemotherapy, radiotherapy, palliative care services, cancer
screening, and a HIV/AIDS care. The Institute serves also private patients, international (foreign)
patients, National Health Insurance Fund (NHIF) beneficiaries and patients from other private
Health Insurance Schemes.

3
1.2.1. ORCI Laboratory Organogram

4
 1.2.2. Size of the Laboratory facility

Facility have three Laboratories The Pathology Laboratory , General laboratory and BIMA
Laboratory where the general laboratory comprises of unit which includes , Serology,
parasitological, hematology, Blood transfusion and phlebotomy.

1.2.3. Facility main role

Ocean Road Cancer Institute (ORCI) is the only comprehensive specialized facility for cancer
care in Tanzania. The Institute was established in June 1996 by an Act number 2 of the
Parliament and is an independent semi-autonomous institute directly under the Ministry of
Health, Community Development, Gender, Elderly and Children.
Currently, the Institute serves more than 50,000 patients that include about 28,000 cancer
patients, 10,000 cancer screening patients, and 12,000 non-cancer patients. In addition, the
Institute attends to over 15,000 clients in the outreach programs in the Tanzania regions.
The Institute works in partnership with the community to create and maintain an integrated,
accessible, and affordable cancer health care system with quality service to improve health and
well-being of its patients.
ORCI offers in patients and outpatients services including laboratory services, diagnostic
imaging, chemotherapy, radiotherapy, palliative care services, cancer screening, and a
HIV/AIDS care. The Institute serves also private patients, international (foreign) patients,
National Health Insurance Fund (NHIF) beneficiaries and patients from other private Health
Insurance Schemes.
Mission:
To provide high quality cancer control services that are equitable, accessible and affordable
through cancer prevention, diagnosis and treatment, research and training in collaboration with
stakeholders.”
Vision:
“To be a centre of excellence with national, regional and international reputation in cancer
control.”
Values:
Integrity, Confidentiality, Collaboration/Teamwork, Empathy, Respect, Accountability and
Excellence

Quality Policy Declaration:

Ocean Road Cancer Institute is implementing 5S-KAIZEN-TQM Approach with the purpose of
improving working environment, quality of services, productivity at workplace, safety and
wastes reduction for a health society.
Our main focus is fulfilling our internal and external client’s expectations through provision of
services which are satisfactory in every conduct.
ORCI has announced to start implementation of 5S-KAIZEN-TQM Approach from January
2019 onwards

5
 1.2.4. Staffing position of the health facility (Laboratory)

CADRE PRESENT

ASSISTANT LABORATORY TECHNOLOGIST 10

LABORATORY TECHNOLOGIST 7

5
LAB & SCIENTISTS

2
DOCTORS/ PATHOLOGIST

3
LAB- ATTENDANT

1.3. CATCHMENT AREA OF THE HEALTH FACILITY AND ITS POPULATION

ORCI-. Serves the coastal zone includes the following regions Dar es salaam, Morogoro, Pwani,
and Tanga. Also regions from central zone Dodoma and Singida.OCEAN ROAD CANCER
INSTITUTE it serves all population in Tanzania since the customers are sent there as a cancer
referral hospital.

1.3.1. THE UNITS SERVED BY ORCI HOSPITAL

There are twenty departments and sections including surgery, internal medicine, OPD / Casualty,
Psychiatry, Radiology, Obstetrics and Gynecology, Pharmacy, Laboratory, Dental,
Physiotherapy, Pediatric, Administrative, Engineering, Ophthalmology, Accounts, Central Store,
Pathology, Orthopedic and Urology.

6
 CHAPTER TWO
2.0. WORKDONE AND THE LESSON LEARNT
2.1. Brief description of task undertaken
During the fieldwork period, I was able to perform different laboratory investigations in
Histopathology, Clinical Chemistry, TB, Hematology, Blood Transfusion, Microbiology and
Other activities related to Laboratory as assigned by laboratory in –charge,

Brief description 0f task undertaken

 RECEPTION –patients information are registration.

 PHELEBOTOMY - Include Collection of specimen, Receiving specimen and
Verification of received sample
 HAEMATOLOGY -Peripheral smear, Full Blood Picture (FBP), Erthrocyte
Sedimentation Rate (ESR), CD4 & CD8 Count
 BLOOD BANK - Haemoglobin Estimation (HB), ABO & Rhesus Blood grouping,
Compatibility test, Coombs direct, Coombs indirect
 PARASITOLOGY - Blood Slide for hemo parasite (B/S), Malaria Rapid Diagnostic Test
(MRDT), Urinalysis, Stool analysis, Urinary Pregnancy Test (UPT)
 CLINICACAL CHEMISTRY - Liver function test, Renal function test, Blood fasting/
Random glucose, Lipid profile, Electrolyte, Prostate Specific Antigen (PSA)
 SEROLOGY - Extended widal test, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV),
Helicobacter Pylori (H.Pylori), Brucella, Rheumatoid factor, Vineral Disease Research
Laboratory (VDRL), Human Immunodeficiency (Virus HIV Test)
 PATHOLOGY AND CYTOLOGY -Body fluids smear preparations and staining
(Pleural, Ascitic, Cerebral Spinal fluid) papanicolous stain, tissue processing, cutting and
staining (H AND E technique), Seminalysis.
 Molecular biology - HIV Viral Load, Gene Xpert (MTB PCR)

7
2.1.1. Introduction
Tuberculosis (TB), an airborne infectious disease, is the third leading` cause of death in
HIV/AIDS patients worldwide (World Health Organization (2007). HIV/AIDS patients
experience different risk factors, social and economic consequences, and barriers to treatment.
Yet little Tanzania is among the 25 countries with the highest tuberculosis burden in the world.8
Of these 25 high burden countries, only three came close to meeting the World Health
Organization (WHO) targets for tuberculosis control, Tanzania being one of these three.8 The
notification rate of smear-positive tuberculosis in Tanzania increased from 38 per 100 000
populations in the period 1983–1987 to 69/100 000 in the period 1993–1997. (Murray, C.J.L. et
al1990).

While tuberculosis prevalence has declined by more than 24% worldwide, the rates in Africa
have tripled since 1990 in countries with high HIV prevalence and are still rising across the
continent at 3.5-6% per year. Between 1998 and 1999, a 24% increase of tuberculosis cases was
reported in countries severely affected by HIV/AIDS in Africa (Kayseret al., 2005). Correct
diagnosis and treatment of tuberculosis help to reduce the burden of tuberculosis, provided that
infectious cases are detected and treated successfully. However, there are difficulties in
achieving the goal of reducing the tuberculosis burden due to a number of challenges, such as
has been done to address the biological differences and gender disparities that present a unique
challenge to the diagnosis and treatment of TB in HIV/AIDS patients (World Health
Organization (2011).

Difficulties in diagnosing tuberculosis in HIV infected patients due to unusual clinical picture
with increase in smear negative acid fast bacilli (AFB negative) pulmonary tuberculosis disease,
and atypical findings on chest radiography. People with HIV are infected with tuberculosis.

TB occurs in every part of the world. In 2011, the largest number of new TB cases occurred in
Asia, accounting for 65% of new cases globally. However, Sub-Saharan Africa carried the
greatest proportion of new per population with over 276 cases per 120 000 populations. In 2011,
about 83% of reported TB cases occurred in 24 countries. Some countries are experiencing major
decline in cases, are among the 24 countries that showed a sustained decline in TB cases over the
past 18 years. China, in particular, has made dramatic progress in TB control. Between 1993 and
2011, the TB death rate in the country fell by almost 71% and the total number of people ill with
TB dropped by half [WHO, 2014].

2.2. Problem statement

Tuberculosis, Is a disease caused by bacteria (mycobacterium tuberculosis) that most often affect
the lungs. Tuberculosis is becoming a world-wide problem, war, famine, homelessness, and a

8
lack of medical care all contribute to the increasing incidence of tuberculosis among
disadvantaged persons. Also TB typically attacks the lungs, but can also affect other parts of the
body. It is spread through the air when people who have an active TB infection cough, sneeze, or
otherwise transmit respiratory fluids through the air. One- third world population is thought to
have been infected with M. tuberculosis and new infections occur in about 1% of the population
each year. In 2007, an estimated 13.7 million chronic cases were active globally while in 2013,
estimated 9million new cases occurred. In 2013 there was between 1.3 and 1.5 million associated
death most of which occurred in developing countries.

2.3. Study Objectives.

2.3.1.Broad Objective.
To know and determine the prevalence of tuberculosis to patient living with HIV/AIDS tested at
ocean road cancer institute laboratory
2.3.2. Specific Objective.
a. To determine the prevalence of tuberculosis to patient living with HIV/AIDS
b. To know the prevalence of tuberculosis to patient living with HIV/AIDS

2.4 Study Questions

i. Why HIV/AIDS patients are likely to infection of tuberculosis?
ii. ARVS dosage to patients are enough supplied?.
iii. Do HIV/AIDS patients pick on time the ARVS?

2.5 Significant of the Study.

This study providing more information on TB to patient living with HIV/AIDS .
Also, the study determines the state of Tuberculosis and provides the educational program,
implementations on how to improve the quality of treatment to patients living with HIV/AIDS.

9
 CHAPTER THREE:
3.0. STUDY METHODOLOGY
3.1. Overview of the Chapter
This chapter explains how a study was carried out. It includes research design, study area, study
population, sampling procedure, sample size, data collection methods, methods for ensuring`,
data analysis methods and plan, ethical consideration of the study, dissemination of research
results, overall limitations of the study.

3.1.1. Study Area

The study was conducted at ocean road cancer institute found at Ilala district at Dare salaam
region.

3.1.2. Study Design

Retrospective study was conducted to know prevalence of tuberculosis in patients with
HIV/AIDS at ORCI, because of limited time and resources especially financial resources but also
the design was convenient and feasible

3.1.3. Study Population

The study population was all 178 HIV patients and tested for tuberculosis, because they are
expected to suffer TB diseases due to their less immunity (immune compromised).
3.2. Inclusion Criteria
Patients with HIV positive and tested for Tuberculosis.
3.3. Exclusion Criteria.
The patients who tested by the symptoms of TB but are negative for HIV.

3.4. Sampling and Sample Size

All intended HIV/AIDS patients attended the ORCI for TB testing or screening purpose were
taken into the study in the duration of six months

3.5. Sampling Technique

Simple random sampling was used to select the participants and the only criteria are Any patients
with HIV and being tested for TB.

3.6. Data Collection Method.

Data were gathered from patient’s files in TB Section electronic storage systems... Data were

10
analyzed using Epi info TM version 7.1.1.1 software (CDC, Atlanta, USA).

3.7. Data Collection Tool.

The data was collected from patient register book and laboratory information system.

3.8. Data Analysis

Data obtained for this study were analyzed manually by tallying and typing using computer.

3.9. Ethical Consideration

The study was conducted in such way that. Permission to conduct the study was sought from
ORCI authorities and finally the ethical clearance was obtained from respective authorities, the
Kilimanjaro health and allied sciences.
Confidentiality, ethical and legal issues was considered, names not be used instead serial number
was used to locate participants.

3.10. Study Limitation

Selection of only patients with HIV/AIDS and being tested with tuberculosis at ORCI only was
likely to be limitation to this study because setting chosen for this study might not be
representative of the real situation in the country.
3.11. Dissemination Findings
The result of this study disseminated to the management team of ORCI, for improvement on
several treatments to HIV/AIDS patients, Kilimanjaro health and allied institute for educational
purpose.

11
 CHAPTER FOUR:
RESULTS/FINDINGS
4.0 Overview of the Chapter
The purpose of this research was to know the prevalence of Tuberculosis diseases among
patients with HIV attending at ORCI.
4.1 Social demographics characteristics,

The patient that was tested with positive TB, male was 16 and female 29 with total of 45.

Table 4.1.1: Data representing interpretation of TB results of male and female patients
from 2023 February to July 2023.

NEGAT POSITIVE NEGATIV

MONTHS IVE TB TB E TB TOTAL
POSITIVE
TB MALES MALES FEMALES FEMALE
TB POSITIVE

FEBRUARY 2 15
5 9 7

MARCH 6 3 12 9
8

3 7
APRILL 10 4 14

MAY 7 9 2 12 9

JUNE 6 3 13 9
10

JULY 2 13 2 8 4

TOTAL
29 16 74 45
59

12
4.1.2 BAR CHART 01: SHOWS THE PREVALENCE OF TB IN HIV PATIENTS AT
OCEAN ROAD CANCER INSTITUTE.

10
9
8
7
6
5
4
3
2
1
0
February march April may June July

4.1.3 Relations of theory learnt in the class to what is happening in the field.

From the practice done in the field it is the application of theories learnt in the class that made
the practice be successful. What is happening in the field station it is exactly the same to what
was learnt in the class, so I was able to perform different investigations but under the aid of
supervisors.

13
 CHAPTER FIVE
5.0. CONCLUSION AND RECOMMENDATION

5.1. Conclusion

Among the HIV/AIDS patients Attended at ORCI screened for TB, the prevalence is 36% female
in all six months where by the highest prevalence is in November, January and February where
male has higher prevalence 64% than female

5.1.2 CHALLENGES

During my field work there were several challenges and this include,

Some of the data were missing in the book.

ORCI laboratory they do not perform ziel nelsen and auramine technique, they do by automated
machine only using gene xpert machine.

Some patients don’t know the effect of late consuming of retroviral drugs.

Some patient doesn’t be tested to know their level of CD4.

5.1.3 Recommendation.

TB programs should work to remove barriers to access, reduce delays, and improve the diagnosis
and treatment of TB in HIV/AIDS patients.

Further research and investigation is needed to understand the inadequacies of diagnosing and
treating TB in HIV/AIDS patients.

All HIV/AIDS patients should be screened for TB and provided appropriate treatment and care
in countries where TB is endemic.

Routine TB screening should be incorporated into maternal and child health programs in
countries where TB is endemic.

TB and infectious disease advocates and maternal and child health advocates must work better
together on a common agenda to eliminate stigma, impact policies and programming, mobilize
resources, and ultimately eliminate TB’s impact in HIV/AIDS patients.

14
5.2 REFFERENCES

Bloch, A.B. etal.The epidemiology of tuberculosis in the United States. Seminar in respiratory
infections, 4: 157-170 (1989).

Center for Disease control, the difference between latent TB infection and Active TB disease,
2011

Colebunders R.L., Rymer R.W. and Nzilambi N.: HIV infection in patient with tuberculosis in
Kinshasa, Zaire. Am Rev Respir Dis

F.H. Kayser, K.A Bienz, J. Ecket and R.M. Zinker nagel. Medical microbiology, Tuberculosis
Bacteria 2005 thieme, and pdf page 264.

Glob report, 2011

Khan, M., Dar, O.et al. (2007). “Improvement of Tuberculosis Case Detection and Reduction of
Discrepancies Between Men and Women by Simple Sputum-Submission Instructions: A
Pragmatic Randomized Controlled Trial.” The Lancet 369(9577): 1955– 60

Kochi, Al.The global tuberculosis situation and the new control strategy of theWorld Health
Organization. Tubercle, 72: 1-6 (1991).

Murray, C.J.L. et al. Tuberculosis in developing countries: burden, intervention and cost.
Bulletin of the International Union against Tuberculosis and Lung Diseases, 65: 6-24 (1990)...

WHO. Tuberculosis 2012, accessed on 05-may-12 from

www.who.int/mediacentre/factsheets/fs104/en/2012

World Health Organization (2004). The Burden of Tuberculosis: Social Burden. Online, World
Health Organization. Accessed 19 May 2010
<http://www.who.int/trade/distance_learning/gpgh/gpgh3/en/index5.html>. Henceforth: WHO,
2004.

World Health Organization (2009a). Global Tuberculosis Control: A Short Update tothe 2009
Report. Geneva, World Health Organization

World Health organization, 2011

15