Modern, Growing, Successful Province

Radio Talkshow:90-90-90 Strategy

Q1. What is the 90-90-90 strategy?
South Africa adopted the 90-90-90 strategy in December 2014 and the country turned a corner in its approach to managing the dual epidemics of HIV and AIDS on the one hand and Tuberculosis (TB) on the other. Together, the two epidemics form the leading cause of deaths in the country. The 90-90-90 strategy is in line with the country’s vision of “a long and healthy life” for all people who live in South Africa and forms part of all the strategies and plans implemented through the government’s programmes of action to address HIV/AIDS and TB. This strategy will be implemented at local/community, facility, sub-district and district levels.

Q2. What are the 90-90-90 strategy cascades (interventions) :

  • Adult HIV care and treatment
  • Prevention of mother-to-child transmission of HIV (PMTCT)
  • HIV treatment for paediatrics under 5 years
  • HIV treatment for paediatrics from 5 to 14 years
  • Drug-sensitive TB
  • Drug-resistant TB treatment
  • TB-HIV co-infected diagnosis and initiation

Q3. What are the 90-90-90 strategy treatment targets?

These are targets set for TB & HIV namely:

TB HIV
-90% of people screened for TB -90% of people living with HIV will know their HIV status
-90% of people with TB diagnosed and treated -90% people with known HIV status will receive antiretroviral medication
-90% of people on TB treatment should be successfully treated       -90% of all people receiving antiretroviral medication will be virally suppressed.


Q4. What are the three(3) TB pillars in the 90-90-90 strategy?

PILLAR 1.  TB SCREENING
90% of people are screened for TB. TB screening is based on four signs and symptoms, however, it differs between adults and children.
Adults

  • Cough for more than two or more weeks. For HIV positive people is for any duration.
  • Drenching night sweat
  • Weight loss of 1.5kg or more
  • Loss of appetite
    Children (5 years & younger)
  • Sudden loss of appetite
  • No interest in breastfeeding
  • Weight loss and failure to thrive
  • Always tired and not playful
  • Drowsiness and excessive sleeplessness

PILLAR 2.  TB TESTING (DIAGNOSIS) & TREATMENT INITIATION
Presumptive is when you have two or more signs/symptoms but for HIV positive person is when you have one or more signs/symptoms (Note: The Clinical Programme Coordinator should expand briefly). Diagnosis is based on sputa collection that’ll be send to laboratory for investigation and if TB is confirmed the patient will be recalled to the facility for treatment initiation (Elaborate).  The facility will send CHW for contact tracing (Elaborate of process).

PILLAR 3. CASE HOLDING (ADHERENCE) & TREATMENT COMPLETION

90% treatment success (cured and completed).
Susceptible TB
Treatment for susceptible TB takes six months and during this period, a person diagnosed with susceptible TB should adhere to treatment for the prescribed period (Elaborate – continuation phases).
When the person is on treatment the person is less infectious (Expand).
DR-TB
Treatment for DR-TB is comprised of two types of treatment regimens:

  • Short regimen – 9 months treatment
  • Longer regimen between 24 and 36 months

Monthly sputa collection for the duration of the treatment period.

Q5. What are the three(3) HIV pillars in the 90-90-90 strategy?

PILLAR 1.    HIV SCREENING/TESTING

Screening of HIV is done using the rapid HIV testing targeting people with unknown status including key and vulnerable populations (expand). 90% of PLHIV (People Living with HIV) know their status.
Key and Vulnerable populations are:

  • TB/HIV Co-infected people
  • Pregnant women
  • Sex workers
  • Youths
  • Young girls
  • Disabled persons
  • Miners
  • Prison inmates
  • Truck drivers
  • Mobile populations e.g. truck drivers, seasonal workers
  • Substance abusers

PILLAR 2    TREATMENT INITIATION

90% of HIV-positive clients on sustained antiretroviral therapy. A person diagnosed with HIV will be recalled to the facility for counselling and treatment initiation. Expand on UTT w.r.t same day testing and initiation, recalling of previously diagnosed patients (i.e. CD4 count 500 and more)

PILLAR 3    TREATMENT ADHERENCE
90% of clients on ART are virally suppressed. HIV is a chronic condition requiring life-long medication (elaborate on importance of adherence and suppression).

Q6. What are the side effects of TB and HIV treatment?

TB

  • Jaundice(Geelsug)
  • Visual impairment
  • Burning
  • Anorexia
  • Nausea
  • Abdominal pains
  • Joint pains
  • Sensation in feet
  • Orange/red urine colour
  • Rash
  • Deafness
  • Vomiting
  • Dizziness

HIV

  • Abdominal Pain
  • Anxiety
  • Depression
  • Dizziness
  • Enlarged Breats
  • Fat Gain
  • Loss of appetite/Nausia
  • Persistent Muscle Pain

Q7. WHAT MESSAGE WOULD TO LIKE TO LEAVE OUR PEOPLE WITH?

  • Each person should take responsibility of their own health by getting tested for TB and HIV.
  • If you are HIV negative, you should maintain this status by practising safe sex like being faithful to one person, use condoms, etc.
  • If you diagnosed with TB and HIV, IMMEDIATELY return to your nearest health facility for counselling and treatment initiation and adhere to treatment and also enroll into Adherence Clubs in your community.

 

Programme is brought to you by the Northern Cape Department of Health

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