Table 1. High Throughput Kakyerere Parish Community Health Campaign Services.
Service Category | Service | Population |
Diagnosis | HIV antibody testinga | All participants |
Point-of-care CD4+ testingb | HIV+ participants | |
TB symptom screeningc | All participants | |
Near point-of-care TB sputum screeningd | HIV+ participants | |
Malaria screeninge | Participants reporting fever in the past 24 hoursm | |
Diabetes screeningf | Adult participants | |
Hypertension screeningg | Adult participants | |
Prevention | Pre- and Post-test counseling for HIV, suspected TB, malaria, hypertension, and diabetes | All participants |
TMP/SMX –30 day supplyh | HIV+ participants | |
Male condoms | Adult participants | |
Vitamin A 200,000 IUi | Children: 6 months –5 years | |
Insecticide-treated bed netsj | All households | |
Treatment | Artemether-Lumefantrinek | Malaria+ participants |
Mebendazole 500 mgl | Children: 1–5 years | |
Referral | Routine scheduled appointments to a local health centre | Participants with HIV, Suspected TB, Diabetes, or Hypertension |
Rapid appointments (<2 weeks) with expedited ART initiation | HIV+ and CD4≤100 cells/µL |
Serial testing algorithm, Uganda National Policy Guidelines for HIV Voluntary Testing and Counseling. [9] HIV rapid test kits: Determine HIV-1/HIV-2 (Abbot); HIV-1/2 Stat-Pak assay; and Uni-Gold HIV Rapid test.
PIMA CD4 (Inverness). Indeterminate CD4+ cell count results were repeated once. Participants with two indeterminate CD4 results were counseled to undergo clinic-based CD4 cell count testing.
HIV+: WHO symptom screening algorithm (current cough, fever, sweats or weight loss) [28]; HIV-: cough >2 weeks.
Xpert MTB/RIF Assay (Cepheid) and direct fluorescent microscopy. Indeterminate Xpert assay results were repeated one time.
Paracheck Pf (P. falciparum) Rapid Test (Orchid Biomedical Systems).
Random blood glucose ≥11.1 mmol/L [32], HemoCue (Quest Diagnostics).
Systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg. [33] All blood pressure measures were performed using automated, electronic pressure cuffs, with small, normal and large cuff sizes available. Blood pressure measures were performed one time; any participant with a positive screen underwent two repeat measurements, including one manual blood pressure cuff measurement.
WHO guidelines on co-trimoxazole prophylaxis for HIV-related infections [34].
WHO guidelines on vitamin A supplementation [35].
Distributed to all parish households after completion of the campaign.
For treating uncomplicated malaria. Severe malaria cases were provided transport to the nearest government hospital.
WHO/Unicef guidelines, 2004 [36].
Cases of fever with hypotension were provided immediate transport to the nearest government hospital. HIV-uninfected participants with non-malarial fever were counseled to seek further evaluation at the nearest government clinic.