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Table 1 Timeline of TB/HIV activities in Cambodia*

From: The multi-step process of building TB/HIV collaboration in Cambodia

Year Type^ Initiating agency Intervention Outcome Challenges
1993 I CENAT DOTS expansion initiated Availability of TB treatment increased Post-conflict environment
1999 P MoH TB/HIV subcommittee formed Dialogue initiated Irregular meetings; limited action
2002 P CENAT and NCHADS Framework for TB/HIV First formal agreement Agreement remained general; technical direction still unclear
2003 I NCHADS ART initiated under Continuum of Care; OI/ART team included TB physician Availability of ART increased Initially low capacity of healthcare system
2003 R NCHADS, CENAT, WHO, FHI, US CDC, JICA TB/HIV pilot programs Pilots initiated and results published; operational challenges highlighted Commitment to national roll-out not present prior to pilots, and relative roles of CENAT and NCHADS were not yet defined
2006 P CENAT and NCHADS SoP on HIV testing of TB patients and TB screening of PLHIV Relative roles of CENAT and NCHADS defined; OI/ART teams screened PLHIV for TB and CENAT used 3 options to increase screening of TB patients for HIV Technical questions remained, i.e., research was needed to define best practices for ART initiation and TB symptom screening prior to IPT
2009 R CENAT, NCHADS, US CDC, Cambodian Health Committee and research partners CAMELIA and ID-TB/HIV studies completed and results disseminated in Cambodia Results define when ART should be started in TB patients and what symptom screen to use in PLHIV prior to IPT Very few challenges; rapid adoption of findings into field practice
2010 P TWG for TB/HIV, NCHADS with CENAT 3Is SOP completed Roll-out of 3Is, based on detailed roles and responsibilities TB screening of existing PLHIV may put burden on TB diagnostic services
2010 P CENAT, NCHADS Revised TB/HIV framework All TB/HIV policy captured in a single document  
  1. *Abbreviations not defined in main text: MoH (Ministry of Health); FHI (Family Health International); US CDC (US Centers for Disease Control); JICA (Japan International Cooperation Agency); TWG (Technical Working Group).
  2. ^Types of activities are research (R), policy (P), and implementation (I).