Engaging Students to Enhance Service Delivery in High HIV/TB Burden communities: The Community Cluster Head Approach in Kisenyi Slum- Kampala City presented by Tumusiime T. , Nabiryo M. , Mirembe R. , and Anecho L.

Background: AIDS Information Centre (AIC) is one of the implementing partners of the USAID Defeat TB Project. The AIC community TB control register identified Kisenyi slum as having the most TB/HIV hotspots in Central division. AIC TB registers indicated that between January and April 2019, out of 60 notified TB cases with 45% TB/HIV Coinfection identified from central division through contact investigation and outreaches, 30 cases came from Kisenyi slum, with Kakajjo, Kasaato and Muzaana zones contributing 12 cases (40%). This prompted a community approach to intensively reach TB hotspots hence an initiative codenamed ‘Community Rise against TB/HIV’.

Materials and Method: AIC established partnership with Integrated Community Health Initiative Organization (ICHIO) – a Makerere University School of Public Health students’ founded initiative. 39 students (volunteers) were engaged and trained in the basics of TB/HIV control at community level.
Kakajjo zone was purposively selected to be the first zone and the Local Council Authority engaged. Clusters of 10 to 15 households were established and Cluster heads for TB/HIV neighbourhood watch nominated by cluster members. Volunteers and VHTs screened and educated cluster members about TB/HIV. Sputum samples collected from those with productive cough were sent for geneXpert test and HIV testing done by AIC staff. Presumptive TB cases were recorded in National TB registers at AIC

Results: 23 clusters were formed in one month and 1,125 people sensitised and screened for TB. 83 sputum samples collected and sent for geneXpert testing and all the 83 presumptive TB patients were tested for HIV as per the national TB/HIV policy.Sputum Sample laboratory analysis yielded 10 new TB and HIV testing yielded 5 HIV positive clients and all linked to care and treatment at AIC and Kisenyi HCIV.

Conclusions: Students (Volunteers) expressed great zeal in providing quality community service while at simultaneously acquiring work experience. The 10 new TB patients and the 5 HIV positive clients identified by this approach demonstrated that communities have greatest and most sustainable human capital which needs to be harnessed and utilised. In addition, the approach used demonstrates that Community clustering can potentially improve community TB /HIV finding and awareness

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