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Tropical Medicine and International Health. 2012 Jun; 17(6):760-6.OBJECTIVE: To review the activities, progress, achievements and challenges of the Zambia Ministry of Health tuberculosis (TB)/HIV collaborative activities over the past decade. METHODS: Analysis of Zambia Ministry of Health National TB and HIV programme documents and external independent programme review reports pertaining to 2000-2010. RESULTS: The number of people testing for HIV increased from 37 557 persons in 2003 to 1 327 995 persons in 2010 nationally. Those receiving anti-retroviral therapy (ART) increased from 143 in 2003 to 344 304 in 2010. The national HIV prevalence estimates declined from 14.3% in 2001 to 13.5% in 2009. The proportion of TB patients being tested for HIV increased from 22.6% in 2006 to 84% in 2010 and approximately 70% were HIV positive. The proportion of the HIV-infected TB patients who: (i) started on ART increased from 38% in 2006 to 50% in 2010; (ii) commenced co-trimoxazole preventive therapy (CPT) increased from 31% in 2006 to 70% in 2010; and (iii) were successfully treated increased to an average of 80% resulting in decline of deaths from 13% in 2006 to 9% in 2010. CONCLUSIONS: The scale-up of TB/HIV collaborative programme activities in Zambia has steadily increased over the past decade resulting in increased testing for TB and HIV, and anti-retroviral (ARV) rollout with improved treatment outcomes among TB patients co-infected with HIV. Getting service delivery points to adhere to WHO guidelines for collaborative TB/HIV activities remains problematic, especially those meant to reduce the burden of TB in people living with HIV/AIDS (PLWHA). (c) 2012 Blackwell Publishing Ltd.
Geneva, Switzerland, WHO, 2004. 60 p.By tracking the past course of the HIV/AIDS epidemic, warning of possible future spread and measuring changes in infection and behaviour over time, second- generation surveillance is designed to produce information that is useful in planning and evaluating HIV/AIDS prevention and care activities over time. This objective has been met in many countries, where useful, high-quality data are now available. Nevertheless, a gap remains between the collection of useful data and the actual use of these data to reduce people's exposure to HIV infection and to improve the lives of those infected. More effort has been put into improving the quality of data collection than into ensuring the appropriate use of data. Collecting high-quality data is an important prerequisite to using them well, but why are available data not used better? One reason is that surveillance systems are often fragmented. This means that many departments or groups are responsible for various aspects of data collection. Each considers its job done after it has held its own "dissemination workshop". No single entity is responsible for compiling all the data, analysing them and presenting them as a cohesive whole. Further, very few countries budget adequately for analysing, presenting and using data, either the financial or human resources. When financial resources are allocated, people often underestimate the skills and time required to use data well. Many surveillance officials responding to an informal WHO/UNAIDS survey gave one final reason: they simply do not know how to use the data. This is hardly surprising: most people responsible for surveillance systems are physicians and public health professionals who are good at interpreting trends in disease but who have limited training in the different ways HIV surveillance data can be used to improve programming, measure the success of prevention, lobby for policy change and engage affected communities in the response. This publication aims to provide guidance in these areas. It discusses the three major areas of data use: programme planning, programme monitoring and evaluation and advocacy, giving examples of how data can be used effectively in these contexts. The publication concentrates on the mechanics of using data: not just what can be done with data but how it can be done. How can data be packaged for different audiences? Who should be involved in dissemination? What makes a good press release? What steps are required to produce a national report? Practical guidance is given on how to develop interesting and persuasive presentations and how to present data effectively. Suggestions are made for bringing together programme planning and advocacy. Different countries have different epidemics, different surveillance systems and different data use needs. It is hoped, however, that all countries can find some general principles that will provide pointers on how to improve performance in areas of data use relevant to them. (excerpt)