SidaGhanaV1, Main, Exploration, bibRecord, 000546

Delivering TB/HIV services in Ghana: a comparative study of service delivery models

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Delivering TB/HIV services in Ghana: a comparative study of service delivery models

Auteurs : Gloria A. Ansa [Royaume-Uni] ; John D. Walley [Royaume-Uni] ; Kamran Siddiqi [Royaume-Uni] ; XIAOLIN WEI [Royaume-Uni]

Source :

Transactions of the Royal Society of Tropical Medicine and Hygiene [ 0035-9203 ] ; 2014.

RBID : Pascal:14-0221022

Descripteurs français

Pascal (Inist)
- SIDA, Ghana, Etude comparative, Modèle, Virus immunodéficience humaine, Indicateur, Médecine tropicale.
Wicri :
- geographic : Ghana.

English descriptors

KwdEn :
- AIDS, Comparative study, Ghana, Human immunodeficiency virus, Indicator, Models, Tropical medicine.

Abstract

Background: TB and HIV interaction increases TB incidence and HIV adverse outcomes. Integration improves patients' access to comprehensive care. This paper compares the impact of increasing integration on TB/HIV service delivery. Methods: Three hospitals with different delivery models were identified and a survey of TB cases registered between June 2007 and December 2008 conducted. HIV screening, co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) uptake for HIV-positive TB patients were compared. Results: Of the 590 TB patients, 85.9% (507/590) knew their HIV status. HIV screening was highest (98.6% [95%CI: 97.6-99.5%]) at the one-stop shop (OSS) and lowest (72.5% [71.9-73.9%]) at the referral site (RS). CPT was highest [(93.8% [91.0-96.7%]) at the RS and least (74.7% [72.8-76.5%]) at the partially-integrated site (PIS). At the OSS it was 82.3% (80.6-84.0%). ART was highest (59.5% [58.0-61.0%]) at the PIS, and 10.8% (10.4-11.1%) at the RS. No ART records existed at the OSS. Conclusions: Increasing integration improved HIV screening but not CPT or ART uptake. There was insufficient evidence to identify the most effective model due to design limitations and health system barriers. More research and training is needed to improve uptake, data completeness and accuracy.

Affiliations:

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Le document en format XML

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<front><div type="abstract" xml:lang="en">Background: TB and HIV interaction increases TB incidence and HIV adverse outcomes. Integration improves patients' access to comprehensive care. This paper compares the impact of increasing integration on TB/HIV service delivery. Methods: Three hospitals with different delivery models were identified and a survey of TB cases registered between June 2007 and December 2008 conducted. HIV screening, co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) uptake for HIV-positive TB patients were compared. Results: Of the 590 TB patients, 85.9% (507/590) knew their HIV status. HIV screening was highest (98.6% [95%CI: 97.6-99.5%]) at the one-stop shop (OSS) and lowest (72.5% [71.9-73.9%]) at the referral site (RS). CPT was highest [(93.8% [91.0-96.7%]) at the RS and least (74.7% [72.8-76.5%]) at the partially-integrated site (PIS). At the OSS it was 82.3% (80.6-84.0%). ART was highest (59.5% [58.0-61.0%]) at the PIS, and 10.8% (10.4-11.1%) at the RS. No ART records existed at the OSS. Conclusions: Increasing integration improved HIV screening but not CPT or ART uptake. There was insufficient evidence to identify the most effective model due to design limitations and health system barriers. More research and training is needed to improve uptake, data completeness and accuracy.</div>
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Le SIDA au Ghana (serveur d'exploration)

Delivering TB/HIV services in Ghana: a comparative study of service delivery models

Delivering TB/HIV services in Ghana: a comparative study of service delivery models

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri