13.3 Mechanism for TB/HIV Referral

All PLHIV are screened for TB using rapid diagnostic tool (Xpert MTB/RIF) at least once a year. Similarly, all MDR patients are screened for HIV during initiation of treatment. Once a PLHIV is diagnosed as having TB, anti TB treatment is initiated immediately and this patient is closely monitored by both the HIV and TB programme by regular documented follow ups. DOT is usually provided by care giver/peer educator.

Currently, in Bangladesh, verbal screening for TB is carried out for all identified key population (KP) visiting any of the service delivery points (i.e. CDIC, DIC, sub-DIC, outlets, etc.) and at community level. Anyone with signs/symptoms of TB (i.e., cough for more than 2 weeks, fever, gradual weight loss etc.) are promptly referred to the government designated TB centres for further management. Diagnosis and treatment are ensured by both the NTP as well as ASP.

All DR TB patients are screened for HIV during initiation of treatment. All TB patients in the 23 priority districts too are screened for HIV at diagnosis. In all the remaining districts, HIV screening is also carried out for complicated TB cases and TB among patients with high-risk behaviour. HIV screening facilities will be available at DOTS centre. Anyone screening positive for HIV will be referred to the nearest ART centre (Annex-) for confirmation and registration followed by initiation of ART. These activities are implemented and followed up by both NTP and ASP.