FRONTESPIZIO - Cooperazione Italiana allo Sviluppo

7. HIV and skin: an operational research (O.R.) in Tigray region, Ethiopia 121treatment methods that could be used in low income countries, together withdidactic needs for health workers.The target groups, trainers and the main topics to be covered during thecourses will be described in the chapters 6.4 and 6.5.This is a brief summary of a model of intervention that could be used in theeducational courses for the health workers and in the process of evaluation ofpatients with suspected STIs and other dermatological diseases in Tigray region:The suspect cases are identified based on clinical symptoms especially if thesymptoms have a history of more than 4 weeks. These suspects are then referredto the laboratory’s room where the collection of the complete clinicalhistory is coordinated. During this first visit the biological samples are collectedfor evaluation:a) the general situation of the principal hematological parameters in the firstday;b) the type of some skin lesions eventually presented; a second specimenwhich is collected when the patient present specific types of coutaneouslesions related to other diseases; this process requires two clinic visits tocollect all the necessary specimens.c) if needs arises and upon agreement with the RHBs, specimen obtainedfrom biopsies of particularly complex cases could be evaluated in Italy(San Gallicano Institute) and the histological diagnosis will be send backin Ethiopia in the next 2-3 weeks, for eventual treatment;d) Patients who return for their results and are found to be positive are immediatelystarted treatment. If there is no response to treatment the patientmay have to be evaluated again. Patients who are negative on the allspecimens are evaluated and observed by the Italian or Ethiopic expertphysicians again and they will be eventually treated.Steps following Dermatological and STIs diagnosis:1. Maintain patient confidentiality at all times.2. Reassure employees with the diseases that treatment is effective.3. Immediately notify the case to the local health authority officer.4. The patients can return to the laboratory once fit enough and no longerinfectious (normally after the first few weeks of treatment). The patientsshould not be discharged with an active disease.5. Collaborate in case management with the local health authority officer, forexample by arranging the best therapeutic opportunity in the workplace,monitoring and follow-up.