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Providing Nurse driven, community supported HIV/AIDS treatment in primary care in rural Lesotho

Lesotho, a small mountainous country, surrounded by South Africa, faces some of the biggest health challenges in Southern Africa. The country is ranked 156 out of 182 nations on the Human development index (1). Lesotho has the third highest HIV prevalence at 23.2 % in 2008 (after Swaziland and Botswana) (2) and is the poorest of the three. At the beginning of 2009 an estimated 119,000 people were in clinical need of ART and by December 2009 a national ART coverage was estimated to be 52% (3). In addition to the burden of HIV, Lesotho has the fifth highest incidence of TB in the world (640/100,000 per year) (4) and a co-infection rate of 76% nationally (3). With ongoing migration between Lesotho and Southern Africa the reality of increasing M/XDR TB incidence has had to be addressed by the government and health partners.