Mbarara, Kabale, and Fort Portal Regional Referral Hospitals should strengthen integrated TB and HIV services

The gap

Evidence profile

Sourced from the recommendations of the source papers, classified as general, drawn from work published between 2024 and 2026, spanning 4 journals.

Supporting evidence — 4 representative gaps

• Clinical Factors Associated with Under-Nutrition among Adult Tuberculosis Patients in Nairobi County, Kenya (2026) · Journal of Health Medicine and Nursing · doi

  Healthcare providers at Tuberculosis (TB) clinics should adopt integrated clinical management protocols that combine TB and HIV care with nutritional support. Regular screening for malnutrition, co-morbidities, and advanced disease stages should be incorporated into clinical workflows. This includes training healthcare workers on the importance of nutritional interventions as part of holistic TB care. Implication to Theory, Practice and Policy The clinical factors such as advanced TB disease stage, HIV co-infection, and under-nutrition supports theories where the disease–nutrition interaction model, which states that infections contribute to malnutrition while malnutrition weakens immune response hence worsening disease progression. This study finding points out the important of incorporating regular assessment of nutritional status into TB protocols. The study recommends screening for HIV and other co-morbidities early and consistently, monitoring of patients with advanced TB disease closely for nutritional decline, counseling into TB treatment plans. Finding of this study may contribute to formulation of policies to promote collaboration between TB programs, HIV programs, and nutrition services to ensure continuity of care. 65 Journal of Health, Medicine and Nursing ISSN 2520-4025 (Online) Vol.12, Issue 2. No.5, pp 54 – 68, 2026 www.iprjb.org REFERENCES Adane, H. T., Howe, R. C., Wassie, L., & Magee, M. J. (2023). Diabetes mellitus is associated with an increased risk of unsuccessful treatment outcomes among drug- susceptible tuberculosis patients in Ethiopia: A prospective health facility-based study. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 31, 100368. https://doi.org/10.1016/j.jctube.2023.100368 Atake, E.-H. (2023). Health system productivity in sub-Saharan Africa: tuberculosis control in high burden countries. Cost Effectiveness and Resource Allocation, 21(1), 90. https://doi.org/10.1186/s12962-023-00485-1 Burusie, A., Enquesilassie, F., Salazar-Austin, N., & Addissie, A. (2024). The magnitude of unfavorable tuberculosis treatment outcomes and their relation with baseline undernutrition and sustained undernutrition among children receiving tuberculosis treatment in central Ethiopia. Heliyon, 10(6), e28040. https://doi.org/10.1016/j.heliyon.2024.e28040 CDC. (2016). Tuberculosis Adverse Events During Treatment. h

  generalrecommendations
  Keywords: tuberculosis disease treatment clinical nutritional care malnutrition advanced nutrition health https healthcare protocols regular screening
• Prevalence, Pattern, and Predictors of Opportunistic Infections in HIV-Infected Children on Antiretroviral Therapy: A Cross-Sectional Study in Plateau State, Nigeria (2026) · Zenodo (CERN European Organization for Nuclear Research) · doi

  Our findings support several actionable recommendations. First, routine TB screening (e.g., WHO four-symptom screen) at every clinical encounter and provision of isoniazid preventive therapy (IPT) to all CLHIV without active TB should be prioritized. Second, CPT should be initiated at HIV diagnosis and continued indefinitely, with intensive adherence support for children and families, particularly those with AHD. Third, regular CD4 monitoring remains essential to identify children at highest OI risk who may require more frequent visits, secondary Fourth, the prophylaxis or AHD-specific interventions. high orphan rate calls for integration of psychosocial and nutritional support into HIV care programmes. Finally, this study underscores the urgent need to strengthen prevention of mother-to-child transmission (PMTCT) to reduce the number of new pediatric HIV infections and consequently AHD. 6,7 17 11 REFERENCES 1. Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV. Guidelines for the Use of Antiretroviral Agents in Ogbu O, Ejeliogu E, Okolo S, Oguche S, Bok M, Onyemocho A Pediatric HIV Infection. Bethesda: National Institutes of Health; 2022. Available from: https://clinicalinfo.hiv.gov/en/guidelines/pediatric- arv/whats-new (accessed 15 May 2026) 2. UNAIDS. Global AIDS Update 2023: The Path That Ends AIDS. Geneva: Joint United Nations Programme on HIV/AIDS; 2023. 3. Gona P, Van Dyke RB, Williams PL, Dankner WM, Chernoff MC, Nachman SA, et al. Incidence of opportunistic and other infections in HIV-infected children in the HAART era. JAMA. 2006;296(3):292-300. 4. B-Lajoie MR, Drouin O, Bartlett G, Nguyen Q, Low A, Gavriilidis G, et al. Incidence and prevalence of opportunistic and other infections and the impact of antiretroviral therapy among HIV-infected children in low- and middle-income countries: a systematic review and meta-analysis. Clin Infect Dis. 2016;62(12):1586-94. 5. World Health Organization. Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach. Geneva: WHO; 2021. Available from: https://www.who.int/publications/i/item/9789240031 593 (accessed 15 May 2026) 6. World Health Organization. Priority Antiretroviral Drugs for the Management of Advanced HIV Disease and Rapid Initiation of Antiretroviral Therapy. Geneva: WHO; 2018. Available from: https://www.who.int/publications/i/item/WHO-CDS- HIV-18.09 (accessed 14 May 2026) 7. World Health Organization. Advanced HIV Disease: When to Start Antiretroviral Therapy, What to Start, and How to Monitor. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/9789240052 598 (accessed 15 May 2026) 8. UNAIDS. Nigeria HIV and AIDS Fact Sheet. Geneva: UNAIDS; 2022. Available from: https://www.unaids.org/en/regionscountries/country/ nigeria (ac

  generalrecommendations
  Keywords: antiretroviral therapy children health available https geneva accessed unaids aids support pediatric infections guidelines world
• Quality of Life among Multidrug-Resistant Tuberculosis Patients in Southwestern Uganda (2026) · Global Journal of Health Sciences · doi

  Mbarara, Kabale, and Fort Portal Regional Referral Hospitals should strengthen integrated TB and HIV services by ensuring routine HIV management, counselling, nutritional assessment, and psychosocial support are provided alongside MDR-TB treatment. This will address the multiple physical and psychological challenges experienced by patients. Health facilities managing MDR-TB patients should incorporate quality of life assessments into routine care to identify patients experiencing difficulties with physical functioning, mental health, social relationships, and financial challenges. Early identification will allow timely referral for appropriate support. MDR-TB programmes should establish structured counselling services, peer-support groups, and family support interventions to address stigma, emotional distress, social isolation, and reduced self-confidence among patients.

  generalrecommendations
  Keywords: support patients referral services routine counselling address physical challenges health social mbarara kabale fort portal
• Assessment of Antiretroviral Therapy Adherence Among HIV/AIDS Patients at Jugel Hospital, Harar, Ethiopia. 2021 (2024) · Journal of Infectious Diseases & Treatments · doi

  1- Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all. 2- Provision adequate of quality and quantity of nutrients and food for patients. 3- Develop plan and implemented advocacy with the relevant authorities to raise awareness with the participation of the community. 4-Training of health personnel to upgrade their scientific knowledge for educating patients about tuberculosis. REFERENCES [1] O. Cosivi, J.M. Grange, C.J. Daborn, M.C. Raviglione, T. Fujikura, D. Cousins, R.A. Robinso H.F.A.K. Huchzermeyer, I.de Kantor, and F.-X. Meslin Emerging Infectious Diseases, 1998; 4: 1. [2] WHO Tuberculosis Infection Control In The Era Of Expanding HIV Care And Treatment- -Limited Settings, 1999. [3] Harms, Jerome Tuberculosis: Captain Death; http://www.bact.wisc.edu/Bact330/lectureTB, 1997. [4] Medicines San Frontiers and Partners‟ in Health, Tuberculosis: Partical guide for clinical, nurses, laboratory technician and medical auxiliaries, 2014. [5] Christine F. Sizemore D. Ritchard H. And Anthony S, National Institute of Allergy and Infectious Diseases. Available on lineat, 2011. http://www.niaid.nih.gov/news/newsreleases/Pages/ WorldTBDay. [6] Cole E, Cook C (1998) Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies. Am J infect Control 26(4): 453-464. [7] Nicas M, Nazaroff WW, Hubbard A (2005) Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. J Occup EnvironHyg 2: 143–154. [8] 8-CDC (2008) Guidelines for the Control of Tuberculosis in the Northern Territory- - 4th edition.

  generalrecommendationsevidence 5/5
  Keywords: tuberculosis health infectious control patients diseases infection care http bact promote sustained inclusive sustainable economic

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