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Training health care workers to promote HIV services for patients with tuberculosis in the Democratic Republic of Congo.

Vanden Driessche K, Sabue M, Dufour W, Behets F, Van Rie A - Hum Resour Health (2009)

Bottom Line: Mean test results increased from 72% pre-training to 87% post-training (p<0.001).Many HCWs did not possess the knowledge or skills necessary to integrate HIV activities into routine care for patients with TB.A participatory approach resulted in training materials that fulfilled local needs.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, USA. Koen@art-rose.be

ABSTRACT

Background: HIV counseling and testing, HIV prevention and provision of HIV care and support are essential activities to reduce the burden of HIV among patients with TB, and should be integrated into routine TB care.

Methods: The development of training materials to promote HIV services for TB patients involved the definition of target health care workers (HCWs); identification of required tasks, skills and knowledge; review of international guidelines; and adaptation of existing training materials for voluntary counseling and testing, prevention of mother-to-child transmission of HIV, and management of opportunistic infections (OIs). Training effectiveness was assessed by means of questionnaires administered pre- and post-training, by correlating post-training results of HCWs with the centre's HIV testing acceptance rates, and through participatory observations at the time of on-site supervisory visits and monthly meetings.

Results: Pre-training assessment identified gaps in basic knowledge of HIV epidemiology, the link between TB and HIV, interpretation of CD4 counts, prevention and management of OIs, and occupational post-exposure prophylaxis (PEP). Opinions on patients' rights and confidentiality varied. Mean test results increased from 72% pre-training to 87% post-training (p<0.001). Important issues regarding HIV epidemiology and PEP remained poorly understood post-training. Mean post-training scores of clinic's HCWs were significantly correlated with the centre's HIV testing acceptance rates (p=0.01). On-site supervisory visits and monthly meetings promoted staff motivation, participatory problem solving and continuing education. Training was also used as an opportunity to improve patient-centred care and HCWs' communication skills.

Conclusion: Many HCWs did not possess the knowledge or skills necessary to integrate HIV activities into routine care for patients with TB. A participatory approach resulted in training materials that fulfilled local needs.

No MeSH data available.


Related in: MedlinePlus

Correlation between mean post-training scores and HIV testing acceptance rate (first 3 months of implementation of HIV activities for TB patients) at 14 primary health care clinics in Kinshasa, DRC.
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Figure 2: Correlation between mean post-training scores and HIV testing acceptance rate (first 3 months of implementation of HIV activities for TB patients) at 14 primary health care clinics in Kinshasa, DRC.

Mentions: High training participation rates were achieved (91% to 100%) at all four consecutive Saturday training sessions and the training received positive feedback from participants. Sixty-five (97%) participants completed the post-training assessment, including 38 nurses, 16 laboratory technicians, 7 physicians and 4 district supervisors. The mean test score increased from 72% pre-training to 87% post-training (p < 0.001). There was no statistically significant difference in post-training score by type of HCW (p = 0.19), with a mean post-training score of 87% for nurses, 86% for laboratory technicians, 89% for physicians and 92% for district supervisors. The mean post-training scores of clinic's HCWs were significantly correlated with the clinic's HIV testing acceptance rate (Fig. 2).


Training health care workers to promote HIV services for patients with tuberculosis in the Democratic Republic of Congo.

Vanden Driessche K, Sabue M, Dufour W, Behets F, Van Rie A - Hum Resour Health (2009)

Correlation between mean post-training scores and HIV testing acceptance rate (first 3 months of implementation of HIV activities for TB patients) at 14 primary health care clinics in Kinshasa, DRC.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2664786&req=5

Figure 2: Correlation between mean post-training scores and HIV testing acceptance rate (first 3 months of implementation of HIV activities for TB patients) at 14 primary health care clinics in Kinshasa, DRC.
Mentions: High training participation rates were achieved (91% to 100%) at all four consecutive Saturday training sessions and the training received positive feedback from participants. Sixty-five (97%) participants completed the post-training assessment, including 38 nurses, 16 laboratory technicians, 7 physicians and 4 district supervisors. The mean test score increased from 72% pre-training to 87% post-training (p < 0.001). There was no statistically significant difference in post-training score by type of HCW (p = 0.19), with a mean post-training score of 87% for nurses, 86% for laboratory technicians, 89% for physicians and 92% for district supervisors. The mean post-training scores of clinic's HCWs were significantly correlated with the clinic's HIV testing acceptance rate (Fig. 2).

Bottom Line: Mean test results increased from 72% pre-training to 87% post-training (p<0.001).Many HCWs did not possess the knowledge or skills necessary to integrate HIV activities into routine care for patients with TB.A participatory approach resulted in training materials that fulfilled local needs.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, USA. Koen@art-rose.be

ABSTRACT

Background: HIV counseling and testing, HIV prevention and provision of HIV care and support are essential activities to reduce the burden of HIV among patients with TB, and should be integrated into routine TB care.

Methods: The development of training materials to promote HIV services for TB patients involved the definition of target health care workers (HCWs); identification of required tasks, skills and knowledge; review of international guidelines; and adaptation of existing training materials for voluntary counseling and testing, prevention of mother-to-child transmission of HIV, and management of opportunistic infections (OIs). Training effectiveness was assessed by means of questionnaires administered pre- and post-training, by correlating post-training results of HCWs with the centre's HIV testing acceptance rates, and through participatory observations at the time of on-site supervisory visits and monthly meetings.

Results: Pre-training assessment identified gaps in basic knowledge of HIV epidemiology, the link between TB and HIV, interpretation of CD4 counts, prevention and management of OIs, and occupational post-exposure prophylaxis (PEP). Opinions on patients' rights and confidentiality varied. Mean test results increased from 72% pre-training to 87% post-training (p<0.001). Important issues regarding HIV epidemiology and PEP remained poorly understood post-training. Mean post-training scores of clinic's HCWs were significantly correlated with the centre's HIV testing acceptance rates (p=0.01). On-site supervisory visits and monthly meetings promoted staff motivation, participatory problem solving and continuing education. Training was also used as an opportunity to improve patient-centred care and HCWs' communication skills.

Conclusion: Many HCWs did not possess the knowledge or skills necessary to integrate HIV activities into routine care for patients with TB. A participatory approach resulted in training materials that fulfilled local needs.

No MeSH data available.


Related in: MedlinePlus