Grantee Information: 

Philanjalo was founded in 1998 and operates from Tugela Ferry, a village at the heart of the Msinga sub district identified as one of the 10 poorest areas in South Africa. They provide community level services for HIV and TB patients and has focused on integrating HIV/TB services for a decade. In addition, they also provide HIV testing services, screen community members for TB, and monitor patients on TB and HIV therapy to evaluate for side effects and complications. They are focused strongly on health education of the patients to improve compliance and overall outcomes. Philanjalo also working in collaboration with Department of Health to provide a comprehensive care package addressing the complex needs to effected and affected HIV and TB people in the community.

Home Based Care Developed a community-based intensive case finding (ICF) public health program to identify patients with HIV, TB, and MDR/XDR TB in Msinga, a rural resource-limited sub-district in KwaZulu Natal Province and reduced the mortality associated with these three convergent epidemics.
Term of Grant: 
Areas Served: 
Msinga, KwaZulu-Natal Province

Article that was written about the project:

The small grants component of the USAID South Africa TB project has been very successful so far in supporting and building the capacity of local NGOs who are implementing interventions that strengthen DOTS. To date the project has funded 19 grantees under Wave One (initiated in 2010) and 18 under Wave Two (initiated in 2011).

URC has seen some outstanding work being carried out from our Wave One grantees, generating numerous success stories and best practices. One such success story is from a grant provided to Philanjalo in Umzinyathi (District 24), KwaZulu Natal in June 2010. The goal of the project was to develop a community based intensive case finding (ICF) program to identify patients with HIV, TB, and MDR/XDR TB in Msinga, an impoverished rural sub district that has been deeply affected by the growing intertwined HIV, TB and MDR/XDR TB epidemics. In 2007, more than half of the provincial MDR/XDR TB caseloads originated in Msinga, and the district suffered a high mortality rate. In many cases, these deaths were the result of late presentation to clinical care due to patient barriers related to socioeconomic status. To meet this challenge, Philajalo’s strategy was to screen for HIV and TB in settings where they could reach the community, specifically ‘pension pay points,’ schools, prisons, taxi ranks, and municipality events and other community gatherings.

Since the start up of the project in Misnga last year, the program has reached approximately 10,000 community members. They were able to do this despite the challenges related to persistent stigma, preference for traditional healers, and lack of access to health facilities. Philanjalo’s team screened 2,466 people for TB and HIV. Of these, they gave sputum bottles to 781 TB suspects and collected 529 samples for laboratory testing for active TB disease. The remaining 525 suspects who were unable to produce samples were referred to their local clinic for additional examination and testing. Sputum testing yielded 3 smear positive cases of TB and 28 culture positives. Drug susceptibility testing of the remaining positive cultures yielded a total of 8 MDR TB cases and 1 XDR TB case. Upon detection these patients began treatment at the M3 Specialized MDR TB Hospital in Greytown and the King George V Hospital in Durban. The ICF project also integrated screening for HIV with their TB tests. This resulted in detection of HIV infection in 253 clients, all of whom were referred to the local ARV clinic. Upon examination at the clinic, 16 of these patients were diagnosed with TB on a clinical basis and were started on TB treatment prior to starting ARVs.

After a visit to Philanjalo made by the project’s field grants team, URC decided to extend its support to the ICF project so that it can scale up its screening and treatment activities. The extended timeline will also enable Philanjalo to conduct outcome-focused clinical follow up of already identified patients and to measure the efficacy of the entire project by following patients through their course of treatment.