Improving indicators of tuberculosis program cascades by leveraging HIV program strategies

Background To improve rates of human immunodeficiency virus (HIV) case detection and treatment, the Nigerian Ministry of Defense Health Implementation Program and the US Army Medical Research Directorate-Africa/Nigeria introduced a HIV standard of care (SOC) package. Given the integration of tuberculosis (TB) and HIV programs and evolving policies, we evaluated the impact of this strategy on TB program indicators. Methods Routine, de-identified program data from 27 Nigerian military hospitals were analyzed. Using Wilcoxon signed-rank test, bivariate analyses were performed to compare data from 12 months before and after implementation of the SOC package. Results Our data showed improvements post-implementation as follows: the number of individuals receiving antiretroviral therapy (ART) screened for TB increased from 14 530 to 29 467 ( P P P P P P P = 0.006), and the number of TB-HIV co-infected clients who started ART increased from 101 to 176 ( P = 0.003). Conclusion The implementation of the updated HIV SOC package led to the improvement in key TB diagnosis and treatment indicators. When emulated, this could help improve the performance of other TB programs in countries other than Nigeria.