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Title: Improving the monitoring of tuberculosis infections in people living with HIV in the Dominican Republic: a cascade of care model
Researchers (UNIBE): King Brito, Jaimee Esperanza 
Báez, Ángela 
Tapia-Barredo, Leandro 
Paulino-Ramírez, Robert 
Affiliations: Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Research area: Ciencias de la Salud
Issue Date: 2018
Publisher: The American Society of Tropical Medicine and Hygiene
Source: The American Journal of Tropical Medicine and Hygiene, 99(4), 620
Journal: The American Journal of Tropical Medicine and Hygiene 
Volume: 99
Issue: 4
Start page: 620
End page: 620
Conference: ASTMH 67th Annual Meeting , New Orleans, USA
Among the opportunistic infections in people living with HIV (PLWHIV), infections with M. tuberculosis appear to be the most common detected. To the date it is estimated a total of 268,500 patients per year in Latin America, and the Dominican Republic it estimated 59.8 cases per 100,000 in the general population, and 12% of co-infection TB/HIV has been reported by 20161,2. This study is aim to propose a cascade of care for the TB/HIV for monitoring of interventions. We collected epidemiological data from three HIV primary care units from the two larger provinces in DR: Santo Domingo, and Santiago. Criteria for a positive TB infection were obtained from clinical records, based on clinical manifestations, and (+) baciloscopy/X-rays. Also, the criterion for a TB infection was not limited to pulmonary, but also included extrapulmonary infections (ganglionar, renal, etc). We analysed data by key populations (MSM/TG, Female Sexual Workers (FSWs), Drug uses (DU), and Migrants. A total of 5537 HIV (+) patients were enrolled in these three centres. Of those, 1% was confirmed as TB (+) (n=71). Among those TB/HIV (+) 41% received treatment, and 11% was considered cured (Figure 1). Among key populations, treatment access was higher (40% GP vs 46% KPs), however, cure rate was lower among KPs (8%) compared with GP (13%). Within those KPs: FSWs and MSM/TG were lower compared with migrants and DU (0% and 9%, respectively). This study revealed a disparity on access to care for tuberculosis treatment between general population and key populations; early access to care, and specific barriers of retention and early management might influence this. When compared between each KP, the lower rate of cure was observed in FSWs and MSM/ TG, these findings are consistent with other studies from the DR where we also observed lower rates of retention in care and not achieving the final goal of finalizing TB treatment. Seems to be a subregistry of TB/HIV cases based on current epidemiological data from the region. This propose model of cascade of care is based on data reported and it is necessary a more intensive screening and retention to achieve the goal of a free TB generation by 2020.
DOI: 10.4269/ajtmh.abstract2018
Appears in Collections:Publicaciones del IMTSAG-UNIBE
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