Tirisanong
Projects Info
Project Manager: Ruth Mathiba
Tel: +27 11 494 1900
.(JavaScript must be enabled to view this email address)
Project Manager: Phethogo Madisha
Tel: +27 11 494 1900
.(JavaScript must be enabled to view this email address)
Anova’s Tirisanong project (“tirisanong” means “working together”) works with the Gauteng Department of Health (DOH) in hospitals and primary care clinics in and around Soweto to support the implementation of the Prevention of Mother to Child Transmission of HIV (PMTCT), as well as the Comprehensive HIV and AIDS Care, Management and Treatment (CCMT) programme.
PMTCT
Tirisanong’s PMTCT programme is active in 13 antenatal facilities in Soweto and the post-partum programme at Chris Hani Baragwanath Hospital in Soweto.
The programme has been receiving USAID funding since 2001. During this time, hundreds of thousands of women have been through the programme and transmission rates have dropped steadily from 35 percent to below four percent. In 2011 Mother-to-child HIV transmission rates were at an all time low of below two percent across all Anova-supported clinic in Soweto.
The project focuses on all aspects of PMTCT, including: counselling and voluntary HIV testing of pregnant women; CD4-count testing; referral for treatment; screening and testing for TB; provision of AZT prophylaxis; guidance on infant feeding; distribution of infant formula provided by the Gauteng DoH; PCR testing of infants; coding of the HIV status of pregnant women; and monitoring and evaluation.
Social mobilisation and the marketing of the programme remain integral to its success, ensuring continued buy-in from the community and a sustained uptake of services. The programme boasts a good uptake of PMTCT services, with 99 percent of pregnant women testing for HIV at their first visit to the clinic.
ART (CCMT)
The Tirisanong CCMT project supports the Gauteng DoH’s Comprehensive HIV/AIDS Care, Management and Treatment (CCMT) programme in the Soweto and Midvaal healthcare facilities.
Access to services and retention in care and treatment are vital components of HIV management. Tirisanong improves infrastructure, builds human capacity and provides technical assistance to contribute towards sustainable services in the long term. This is based on the understanding that much can be achieved through good communication, and as part of its strategy, the programme has established sound communication with stakeholders in the clinics, project managers in non-government sites, and community structures. Important achievements include the establishment of a clinical HIV treatment forum to discuss and present on complicated patients on antiretroviral treatment as well as a training curriculum for healthcare workers.
The Tirisanong project focuses on building capacity in CCMT services and on facilitating the referral of stable HIV-positive patients across primary healthcare clinics in these areas, thus increasing their access to life-saving ART.
The Tirisanong project supports 16 healthcare facilities, 11 initiation or CCMT sites and five maintenance sites. The Tirisanong project was involved in preparing Meadowlands, Mandela Sisulu and PHRU as ART initiation sites, and in March 2010 all three clinics were approved as CCMT sites.
Over the last year Anova has, through Tirisanong, supported the renovation of four provincial clinics. The Meadowlands Clinic ART site was opened by the provincial Minister of Health in May 2010 and the event was recognised as symbolic of the benefits of the partnership between the South African government, USAID/PEPFAR and Anova.
Life-saving treatment
Lillian Ngoyi Clinic: Soweto
Ms TN, originally from the Eastern Cape, works as a domestic worker in Johannesburg. Her employer, a medical doctor, was very worried because she noticed that her domestic worker was literally ‘wasting away.’ She took the lady to Lillian Ngoyi Clinic. It was not easy to get much information out of the patient because of employment concerns, but after much reassurance she agreed to get tested. She had been worried that she may lose her job and be sent back to the Eastern Cape. Her CD4 count was 30; she was very weak and wasn’t eating well. She had severe oral candida. This was treated and she was started on Bactrim. TB was precluded as a possibility. She started attending the drug-readiness sessions. Two weeks later she was a different person. She managed to come to the clinic on her own and start ARVs.
A month later she had gained about 5kgs and she was back to normal. She is thriving and doing very well at work. Her employer is now aware of her status, and always makes sure that she visits a clinic every month. Ms TN is always grateful for what the Tirisanong doctor and other healthcare workers did for her. “She never forgets to stop by and say hello and tell us she is still taking her treatment faithfully,” they say.
Paediatric ART
Chiawelo clinic Soweto
The Tirisanong team supports Chiawelo clinic with paediatric HIV/AIDS management and enrolling children on ART. Currently the clinic has over 50 children on ART who are stable and active. The biggest success of the intervention has been to reduce morbidity and the mortality rate by 80 percent in children started on antiretrovirals at an early stage.
The Tirisanong doctor works closely with the primary healthcare nurse who he mentors in the management of children. There is a success story of a three-year-old girl who was brought in by her grandmother after her parents passed away, and the little girl tested HIV positive. Her CD4 count was less than 15 pe cent (normally it would be well above 25 percent). She had recurrent pneumonia and was often hospitalised at the Chris Hani Baragwanath hospital. When the doctor saw her, she was very ill and healthcare workers said the granny was tired of constantly running to the hospital.
The doctor started her on ARVs and within two months the child gained weight and the risk of pneumonia was gone. Healthcare workers said, “The granny could rest and take a break from the hospital.” They say the child is well and her CD4 count has improved significantly. She is helping her grandmother to look after the house.
TB programme
Routine TB screening among pregnant women was introduced in Tirisanong’s PMTCT programme in Soweto in October 2009 and is now offered in all antenatal clinics. The clinical screening process involves enquiring about symptoms suggestive of TB infection, and if the screening is positive, special investigations are done to confirm a diagnosis of TB. A TB screening form for the antenatal clinics was also developed and is used for data collection.
Between October 2009 and September 2010, 19 476 pregnant women (both HIV-positive and negative) were screened for TB. Of these, 983 (8.43 percent) were TB suspects, and only 3 (0.3 percent) of those were confirmed TB cases.
A study conducted in some of the antenatal clinics in the Soweto PMTCT programme between December 2008 and July 2009 found similar figures of TB prevalence (less than 1 percent).
Tirisanong ART Sites:
