Sharing the expertise of a world-class university with our partners in Botswana to build capacity and excellence in clinical care, education, and research.
HIV Care and Support
The HIV Care and Support Program aims to improve the quality of care received by HIV positive individuals in Botswana. The program provides technical support through: outreach, service training of internal medicine residents, interns and medical students from the UB and technical support for the MOH HIV resistance clinic and inpatient medical guideline development. Botswana has the 2nd highest rate of HIV prevalence in the world with about 25% of the population infected. Currently, just over half of the patients we see are HIV positive, reflecting the need for specialist service in the districts.
Two major Adult TB/HIV Program priorities complement the Botswana National TB Program’s (BNTP) strategic plan for 2008-2012: integration of TB/HIV services and prevention and management of complicated TB, TB/HIV and Drug Resistant-TB. BUP addresses these priorities through direct clinical care, teaching and mentorship, outreach services to health facilities nationwide, and technical assistance to the MOH. An additional priority has been support to the UBSOM in teaching and clinical mentoring at the undergraduate and post graduate levels, especially the departments of Internal Medicine and Family Medicine.
The Adult TB-HIV Program aims to provide ongoing training and support to new and established MOH clinicians at four of the five MDR-TB treatment centers in Gaborone, Francistown, Maun, and Ghanzi. The fifth site (Serowe) has a dedicated infectious disease specialist onsite who supports the MDR clinic. BUP support to the MDR clinics has included monthly outreach visits to Maun, outreach visits every few months to Ghanzi with additional phone support as needed, and daily support to Francistown and Gaborone. Since September 2011, a majority of direct clinical care at PMH and NRH TB/HIV Clinics has been by trained MOH clinicians. In the second quarter the new TB medical officers in Francistown and Gaborone continued working in the TB clinics, under daily supervision and mentorship of BUP specialists. The demand for services in Francistown and Gaborone continues to be significant due to molecular diagnostics (GeneXpert), referrals of complicated TB/HIV cases from inpatient services and outlying hospitals, and expanded MDR-TB contact tracing efforts. Monthly BUP outreach continued to Maun, to support both the MDR clinic and the UB Family Medicine program.
BUP pediatricians work closely with the BNTP and are technical advisors on all aspects of pediatric TB. Since the publication of the revised National TB guidelines, our team has distributed the updated pediatric section of the TB case management at many of our trainings. We have also continued to give site specific feedback and engage workers on barriers to guideline appropriate evaluations of children with TB. This has been done using the data collected through the gastric aspirate program. Training figures for these sessions are incorporated in the training figures for the gastric aspirate report.
As part of its Pediatric TB program, BUP works with the BNTP to reinvigorate TB contact tracing. The team’s initial focus was twofold: to complete contact tracing for (1) all cases of pediatric TB diagnosed at PMH; and (2) adult, MDR-TB cases who live within 50km radius of Gaborone’s city center. Since May 2009, the team has extended its activities to a third area – (3) contact tracing is now supported at the two busiest TB clinics in Gaborone (Old Naledi and Broadhurst III clinics). Currently the BUP contact tracing team operates from seven sites
Furthermore the contact tracing team has expanded its scope by collaborating with other community based organizations involved in TB work.