Shetty P V D, Granich R M, Patil A B, Sawant S K, Sahu S, Wares D F, Chauhan L S, Joshi P L
Office of World Health Organization Representative to India, New Delhi, India.
Int J Tuberc Lung Dis. 2008 Mar;12(3 Suppl 1):26-31.
India has a high tuberculosis (TB) burden, with 1.8 million new cases per year. Although an estimated 2.5 million people are infected with human immunodeficiency virus (HIV), the national HIV prevalence is <1%. India's size and diverse TB-HIV epidemiology pose a major challenge to the implementation of links between TB and HIV/AIDS programme services.
A pilot cross-referral initiative was instituted between voluntary counselling and testing centres (VCT) and the diagnostic and treatment facilities of the Revised National TB Control Programme (RNTCP) in four districts of Maharashtra, India.
To detect TB disease among VCT patients and selectively screen TB patients for referral to VCT services.
Between July 2003 and June 2004, 336 (3%) of 9921 VCT patients were identified as TB suspects and 83 (29%) were diagnosed with TB disease. Of the 765 selectively referred TB cases, 181 (24%) were found to be HIV-positive, representing 11% of the newly detected persons living with HIV in the four districts.
The pilot cross-referral initiative yielded significant numbers of active TB cases among VCT patients and HIV-positive persons among TB patients. Collaborative activities between HIV/AIDS and TB programmes need to be rapidly scaled up to other states in India.
印度结核病负担沉重，每年有180万新发病例。尽管估计有250万人感染了人类免疫缺陷病毒（HIV），但全国HIV流行率<1%。印度幅员辽阔，结核病与HIV的流行病学情况多样，这对结核病与HIV/艾滋病项目服务之间建立联系的实施构成了重大挑战。
在印度马哈拉施特拉邦的四个区，在自愿咨询和检测中心（VCT）与修订后的国家结核病控制规划（RNTCP）的诊断和治疗机构之间开展了一项试点交叉转诊倡议。
在VCT患者中检测结核病，并选择性地筛查结核病患者以便转诊至VCT服务。
在2003年7月至2004年6月期间，9921名VCT患者中有336名（3%）被确定为结核病疑似患者，其中83名（29%）被诊断为结核病。在765例被选择性转诊的结核病病例中，181例（24%）被发现HIV呈阳性，占这四个区新发现的HIV感染者的11%。
试点交叉转诊倡议在VCT患者中发现了大量活动性结核病病例，在结核病患者中发现了大量HIV阳性者。HIV/艾滋病项目与结核病项目之间的合作活动需要迅速扩大到印度的其他邦。
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