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Module Description

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The goal of this module is to prepare learners to provide team-based care and follow up for a patient with HIV and pulmonary TB. This module exemplifies role clarification and use of evidence-based medicine/ country-specific guidelines. 

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Objectives

By the end of the module, the learner will be able to:

  1. Describe a diagnostic approach to pulmonary TB in a patient recently diagnosed with HIV
  2. Describe when and which ART to start in a patient on TB therapy and identify drug-drug interactions between HIV and TB medications
  3. Describe how to counsel a patient on side effects and toxicities & suggest a follow-up plan for a patient with HIV-TB co-infection
  4. Recognize the psychosocial implications of TB
  5. Describe how to manage transaminitis in a patient with HIV-TB co-infection
  6. Recognize the importance of and describe how to initiate a household contact evaluation plan for this patient (QI)
  7. Identify indications for and drug options for TB preventive therapy  

Optimizing Team-Based Care to Achieve High Quality HIV Care

Central to this module, facilitators should prompt all learners to consider how they can deliver care that fosters optimized team-based care to ensure high quality HIV care. Consider how the case enables learners to gain greater competency in the following domains:

  • Values and ethics: Work with individuals of other professions to maintain a climate of mutual respect and shared values.
  • Roles/responsibilities: Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations.
  • Interprofessional Communication: Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease.
  • Teams and Teamwork: Apply the values and principles of team dynamics to build relationships and perform effectively in different team roles to plan, deliver and evaluate person-centered care and population health programs and policies that are safe, timely, efficient, effective and equitable. 

ABBREVIATIONS

LTBI    Latent tuberculosis infection

PWH People with HIV

PTB     Pulmonary TB

R         Rifampicin

TB       Tuberculosis

TPT     Tuberculosis preventive therapy

Z          Pyrazinamide

AFB     acid fast bacilli

ART    antiretroviral therapy

E          Ethambutol

H         Isoniazid

HIV RNA        HIV ribonucleic acid or viral load

LAM   lipoarabinomannan