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No. 1, 2006


Workshop Helps Prepare Botswana for Scale-up of HIV Testing in TB Clinics

Staff of two DTBE branches, the International Research and Programs Branch (IRPB) and the Communications, Education, and Behavioral Studies Branch (CEBSB), collaborated with CDC’s Global AIDS Program (GAP) to develop training materials and present a TB/HIV Surveillance Training of Trainers (TOT) Workshop last July in Gaborone, Botswana. Botswana’s Ministry of Health (MOH) and National TB Programme (BNTP), BOTUSA (CDC-GAP office in Botswana), the International Union Against TB and Lung Disease (IUATLD), and the World Health Organization (WHO) also supported the workshop.

The purpose of the workshop was to

  • Expand routine HIV testing (with counseling and referral) of TB patients in Botswana
  • Introduce the new TB recording forms that include variables on HIV status, antiretroviral therapy (ART) use, and isoniazid preventive therapy (IPT) use
  • Learn how to properly collect and record TB/HIV data using the TB treatment card and TB register
  • Build capacity by creating a cadre of district-level trainers

About 80 participants attended the workshop, including TB coordinators, community health nurses, and AIDS/STD unit representatives, from all 24 districts in Botswana. These participants will serve as trainers during Botswana’s upcoming national rollout of TB/HIV surveillance training to facility-level staff in each district.

meeting facilitator

The facilitators used the “Teachback” methodology, allowing the participants to both receive and present core module materials that incorporate CDC and WHO best practices for TB/HIV surveillance. This methodology develops the training skills of participants, thereby building future training capacity in the country.

The following TB/HIV core training modules were field tested at the workshop:

  • Introduction to TB/HIV
  • Expanding routine HIV testing of TB patients
  • TB recording and reporting and new HIV variables
  • Use of TB/HIV data at the facility level

Updated versions of these core modules will be used in the Botswana districts and by other sub-Saharan African countries that are experiencing high rates of TB/HIV coinfection.

The remaining six modules, specifically targeting district-level staff, were also field tested at the workshop. These modules will not be used in the facility-level trainings, but did teach essential skills for TB/HIV recording and reporting at the district level, including

  • Supervision of surveillance activities
  • Using surveillance for monitoring and evaluation
  • Use of TB/HIV data at the district level
  • Using the Electronic TB Register
  • TB surveillance in HIV care and treatment settings
  • IPT surveillance
  • Development of training strategies (Action Plans)

The workshop was well received by the course participants as well as the supporting facilitators. Dr. Robert Makombe of the WHO Regional Office for Africa (AFRO) and a facilitator for the training course, called the workshop “a most wonderful time spent learning and teaching new things, sharing experiences, and working out future areas of collaboration, all in a friendly and professional atmosphere.”

Since the TOT workshop ended on August 1, 2005, the DTBE/GAP team has worked with BNTP and BOTUSA staff to modify the core modules and prepare for a Botswana national rollout of TB/HIV facility-level trainings, scheduled to take place between October 2005 and May 2006. To date, seven districts have conducted trainings for various health staff involved in TB recording and reporting, including nurses, doctors, family welfare educators, pharmacy technicians, and midwives.

training of trainers

The TB/HIV Surveillance Training-of-Trainers Workshop training materials are currently undergoing final revisions and will be submitted for CDC clearance in early 2006. These materials will be available for use in other GAP countries at that time. Please contact Lisa Nelson (, Kelly Stinson (, or Bryan Kim ( for further information.

—Submitted by Kelly Stinson, MPH
Div of TB Elimination



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