SOUTH SUDAN

EASTERN EQUATORIA STATE

TB/HIV ANNUAL REVIEW MEETING

May 2022
EASTERN EQUATORIA STATE
BY
FLORENCE ALFRED
TB/HIV COORDINATOR
EES
Overview of the Presentation
• General state overview (Counties, Facilities, TB-HIV/AIDS services,
IPs, current status of services)
• Updates on Indicator performance by facility (Jan – Dec 2021)
 First 95
 2nd 95
 3rd 95
• HIV program achievements in the state
• Best practices & lessons learnt
• Program gaps & Challenges
• Opportunities in the state
• Recommendations & Ways forward
State Overview
EES Health facilities:
• Hospitals 5
• PHCC 35
• PHCU 94
Total TB Facilities 32
Total number of HIV sites
1. VCT Sites 8
2. ART Sites 16
3. PMTCT Site 8
 State Overview
Internal Borders: North West- Jongolei State
West: Central Equatoria State
North East: Pibor administrative area
International Borders: South :Uganda,
North West: Kenya,
North East: Ethiopia.
• The population of EES stands at 1.333.120 (2008 Sudan Census).
• The state has 8 counties with 134 health facilities (including 5 hospitals, 35
PHCCs, & 94 PHCUS) 32 facilities offer TB and/or HIV/AIDS.
• Main partners for TB/HIV are Cordaid & ICAP.
• 3.1% (2012) Prevalence and 41,326 people estimated to be living with the
virus.
• 12,000 (29% of population at risk) know their HIV status and 8,000 are living
 TB-HIV Implementing Partners in the State
Name of County of Area(s) of Support Facilities Supported by IP
IP Presence
CORDAID Kapoeta South, Provides TB/HIV drugs 1 State Hospital, 5 County Hospitals, 34
Kapoeta East, and reagent, incentive PHCCs.
Kapoeta North, for staff, support
Torit, Magwi, trainings and support
Lafon, Budi and joint field supervisions
Ikotos. with SMoH/CHD
ICAP Torit, Magwi, Hires qualified staff Torit County: Torit State Hospital,
Ikwotos, Kapoeta and provides airtimes Nyong PHCC, Hiyala.
South, Kapoeta to government Magwi County: Nimule County
North, Kapoeta employees in HIV Hospital, Magwi PHCC, Abara PHCC,
East and Ikwotos department. Lobone PHCC, PHCC, Pageri PHCC
Counties. Ikwotos: St Theresa Mission Hospital/
Isohe
Kapoeta South: Kapoeta Civil Hospital,
 HIV Service Availability Per County (# of Facilities)
Name of County HTS PMTCT EID ART VL HIV/TB TB

Magwi County 8 7 7 8 8 6 0

Torit County 3 3 3 3 3 3 4

Lopa/Lafon County 0 0 0 0 0 0 2

Ikwotos County 1 1 1 1 1 1 4

Kapoeta North County 1 1 1 1 1 1 0

Kapoeta East County 1 1 1 1 1 1 3

Budi County 1 1 0 1 0 1 4

Kapoeta South County 3 2 2 2 2 3 0

Total 18 16 15 17 15 16 17
 HIV Status in the State (Cumulative Jan-Dec 2021)

NAME OF COUNTY PEOPLE TESTED ON ART VIRALLY DEATHS

TESTED POSITIVE SUPPRESSED

Budi County 160 5 116 -

Ikotos County 3,937 213 3,353 111

Kapoeta East County 1,435 87 274 -

Kapoeta North County 2,502 50 479 2

Kapoeta South County 14,304 648 8,266 121

Magwi County 25,206 437 26,115 1,537

Torit County 8,265 218 7,797 317

TSTATE TOTALS
55,809 1,658 46,400 2,088
 Updates on Performance Indicators Per Facility (Jan – Dec 2021)
Name of Facility HTS (Tested) HTS (Pos) On ART VLS PMTCT PMTCT (EID) (by 2mo) TB IP
(ART) (ART)
Abara PHCC 1967 45 102 4 3 2 0 IC
Chukudum HOSP 160 5 116 - 0 0 0 C
Hiyala PHCC 445 95 64 - 0 0 0 IC
Kapoeta Civil Hosp 10300 495 888 117 22 37 19 IC
Kapoeta M Hosp 4004 84 - 0 0 0 C
Lobone PHCC 1956 52 221 92 5 20 1 IC
Magwi PHCC 3798 50 261 - 13 13 8 IC
Narus PHCC 1435 87 66 - 1 1 0 IC
Nimule HOSP 1534 1232 66 65 22 IC
9483 163
Nyong PHCC 1565 37 140 - 37 19 0 IC
Obbo PHCC 2766 75 112 71 8 6 1 IC
Pageri PHCC 966 5 14 - 0 0 0 IC
Pajok PHCC 1037 19 65 42 0 3 0 IC
Riwoto PHCC 2502 35 61 2 0 0 0 IC
St Theresa M 3937 213 335 111 3 15 8 IC
Torit State HOSP 6255 86 815 263 37 17 IC
 2nd 95 - ART Performance in the State (Jan-Dec 2021)
HIV tests positive
Facility 0-14 years 15+ years 0-14 years
Abara PHCC 2 43
Chukudum HOSPITAL 1 4
Hiyala PHCC 0 95
Kapoeta Civil Hospital 48 447
Kapoeta Mission Hospital 2 82
Lobone PHCC 5 47
Magwi PHCC 1 49
Narus PHCC 5 82
Nimule HOSPITAL 14 149
Nyong PHCC 0 37
Obbo PHCC 1 74
Pageri PHCC 0 5
Pajok PHCC 1 18
Riwoto PHCC 3 32
St Theresa M Hosp 4 209
Torit State HOSPITAL 7 79
Total 94 1452
PLHIV new on ART
15+ years
2 22
0 4
0 39
11 315
2 82
7 51
1 50
5 64
20 328
1 37
1 24
1 15
1 19
3 43
4 89
6 80
63 1180
 3rd 95 – Viral Suppression Performance in State (Jan-Dec 2021)

2021 EE VL samples collected and suppressed

VL Samples Collected
1400 1232
1200
Number of samples collected

1000
800
600 422
400 221 132 248 259
200 62 21 91 111 120 52 41
0

Health Facilities
 3rd 95 – Viral Suppression Performance in State (Jan-Dec 2021)

VL Results with VL Results with

VL Samples HVL(>1000c/ml suppressed VL Suppression
Facilities Collected Results returned ) (<1000 copies/ml) Rate (%)
Abara PHCC 62 5 1 4 80%
Kapoeta Civil Hosp 422 117 0 117 100%
Lobone PHCC 221 92 0 92 100%
Magwi PHCC 132 46 0 46 100%
Nak Nak PHCU 21 7 3 4 57%
Nimule HOSPITAL 1108 1335 103 1232 92%
Nyong PHCC 91 63 9 54 86%
Obbo PHCC 111 82 11 71 87%
Pajok PHCC 52 50 8 42 84%
Riwoto PHCC 41 3 1 2 67%
St Theresa M HOSP 248 127 16 111 87%
Torit State
HOSPITAL 259 263 0 263 100%
HIV PROGRAM ACHIE VEMENT

• Joint supportive supervision and mentorship in 6 Counties, Ikwotos,

Magwi, Budi ,Kapoeta South, Lopa/Lafon and Torit county.
• 30 participants attended 5 days training on pharmacovigilance and
supply chain. In coordination with NTP, 30 participants were trained
on HTS. And;
 Acheivement cont
• Reactivated HIVAID services in Chukudum and Kapoeta Mission
Hospitals.
• Integrated HIV/AIDs/ TB care Services in Napetiet PHCC.
• 40 Participants trained on DHIS2 in Torit to support HIV/TB
reporting.
• Distributed tablets to facilities to strengthen DHIS2 report
 Achievement Cont.

• Role out viral load and EID services in remaining health

facilities
Best Practices and Lessons Learned

•Nutrition support provided by the WFP improve retention

•Motivation provided to HIV/TB units at facilities improves performances and;

•Coordinated supportive supervisions has enhanced performances

.
Gaps and challenges during Jan-Dec 2021
1. Stigma and discrimination due to bad cultural/ belief practices
2. tracking lost to follow up clients is very difficult
3. Poor communication network and poor transports system.
4. Delay of commodities delivery to hard to reach areas
5. Insecurity limits access to some health facilities
6. Minimum referral of VL and EID.
7. High LTFU ( poor retention)
8. Lack of fund to HIV/TB Coordination office limits activities.
 Recommendation and Ways forwards
• Awareness creation through talk show and Health Education in facility
• Provision of transport mobility to improve supportive supervision activities to
the TB unit in SMoH
• Capacitate staff in HIV/TB units on EID and viral load

• Quick integration of ART in remaining facilities.

• 40 more participants trained on DHIS2 in Torit.
• State TB/HIV Coordination office be fully financed.

• Incentive as the best practice for HR retention.

 TB Case Notification
Block 1: All TB cases registered during the quarter b New Relapse Previously treated Previous treatment Total
(excluding relapse) history unknown
Pulmonary, bacteriologically confirmed  986 65  70  0  1121
Pulmonary, clinically diagnosed  454 33  19  11  517
Extrapulmonary, bacteriologically confirmed or clinically diagnosed  362 23  3  0  388

Block 2. All new and relapse cases (bacteriologically confirmed or clinically diagnosed) registered during the quarter by age group and sex 
  0-4 5-14 15-24 25-34 35-44 45-54 55-64 >65 Total (New & Relapses)
Male  50  79  163  286  296 132  1 63 36  1205
Female  44  106 79  102  121  150  85 71  758
Block 3: Laboratory diagnostic activity
Patients with presumptive TB Patients with presumptive TB
undergoing bacteriological 6249 with positive bacteriological 1121
examination examination result
Block 4: TB/HIV activities (all new and relapse TB cases registered during the quarter)
Patients tested for HIV at the time of TB diagnosis or HIV-positive TB patients on
HIV-positive TB patients HIV-positive TB patients on CPT
with known HIV statusd at the time of TB diagnosis ART
1923  136  136  136 

Block 5. TB/HIV co-infected patients among new and relapse registered during the quarter by age group and sex 
Total (New &
0-4 5-14 15-24 25-34 35-44 45-54 55-64 >65
Relapses)
 
Male  1  0  6 28  38  14  3   0 100 
Female  0 0  7  16  7  6  0  0   36
S/N
S/N HF
HF Registered
Registered Completed
Completed TSR TSR

1 Bira 22 11 50 50%
2 Chukudum 151
151 138
138 91 91%
3
3 Helleu
Helleu 30
30 29
29 97 97%
4 Hiyala 14 14 100%
4
Hiyala
Ikwoto 14
11 14
7 50% 100%
5
5 Imehejek 14
Ikwoto 11 712 91% 63%
6 Imotong 3 2 50%
Imehejek 14 12 91%
7
7 Kapoeta
Imotong
M.Hospital 3254 2126 49% 67%
8
Kapoeta
M.Hospital 254 126 49%
S/N HF Registered Completed TSR
Kapoeta S
9 Hospital 187 148 79%
10 Hatire 1 1 100%
11 Kudo 9 9 100%
12 Lobone 20 18 90%
13 Lorema 4 3 75%
14 Lowoi 14 12 76%
15 Magwi 71 47 66%
16 Nagishot 12 9 75%
17 Narus 24 22 91%
18 Ngauro 29 24 83%
S/N HF Registered Completed TSR
20Nyong 0 0 0
21Obbo 1 1 100%
22Oronyo 10 9 90%
23Pajok 7 6 90%
24Riwoto 13 12 90%
St Theresa M
26 Hosp 55 47 85%
Torit State
27 Hospital 259 208 80%
28Lafon 5 5 100%
29Abara 0 0 0
Opportunities in the State
• Presence of Implementing partners like CordAid, ICAP,
WFP. CARITAS

• Hospitals, PHCC , Availability of TB/HIV Drugs, HIV

testing Kits and TB reagents
• Availability of technical Staff ( Trained Human resources)

• Support from.(NEPWU ,People of Hope and SENP)

After PITC Training in Torit
Thank you!

Questions? Comments?