Delivering TB/HIV services in Ghana: a comparative study of service delivery models
Identifieur interne : 000005 ( PascalFrancis/Checkpoint ); précédent : 000004; suivant : 000006Delivering 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.
Descripteurs français
- Pascal (Inist)
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
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.
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Ansa</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road</s1><s2>Leeds LS2 9LJ</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds LS2 9LJ</wicri:noRegion><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Walley, John D" sort="Walley, John D" uniqKey="Walley J" first="John D." last="Walley">John D. Walley</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road</s1><s2>Leeds LS2 9LJ</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds LS2 9LJ</wicri:noRegion><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Siddiqi, Kamran" sort="Siddiqi, Kamran" uniqKey="Siddiqi K" first="Kamran" last="Siddiqi">Kamran Siddiqi</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road</s1><s2>Leeds LS2 9LJ</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds LS2 9LJ</wicri:noRegion><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Xiaolin Wei" sort="Xiaolin Wei" uniqKey="Xiaolin Wei" last="Xiaolin Wei">XIAOLIN WEI</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road</s1><s2>Leeds LS2 9LJ</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds LS2 9LJ</wicri:noRegion><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbreviated">Trans. r. soc. trop. med. hyg.</title><idno type="ISSN">0035-9203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbreviated">Trans. r. soc. trop. med. hyg.</title><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Comparative study</term><term>Ghana</term><term>Human immunodeficiency virus</term><term>Indicator</term><term>Models</term><term>Tropical medicine</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>SIDA</term><term>Ghana</term><term>Etude comparative</term><term>Modèle</term><term>Virus immunodéficience humaine</term><term>Indicateur</term><term>Médecine tropicale</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><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></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0035-9203</s0></fA01><fA02 i1="01"><s0>TRSTAZ</s0></fA02><fA03 i2="1"><s0>Trans. r. soc. trop. med. hyg.</s0></fA03><fA05><s2>108</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Delivering TB/HIV services in Ghana: a comparative study of service delivery models</s1></fA08><fA11 i1="01" i2="1"><s1>ANSA (Gloria A.)</s1></fA11><fA11 i1="02" i2="1"><s1>WALLEY (John D.)</s1></fA11><fA11 i1="03" i2="1"><s1>SIDDIQI (Kamran)</s1></fA11><fA11 i1="04" i2="1"><s1>XIAOLIN WEI</s1></fA11><fA14 i1="01"><s1>Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road</s1><s2>Leeds LS2 9LJ</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA20><s1>560-567</s1></fA20><fA21><s1>2014</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>3084</s2><s5>354000504843030090</s5></fA43><fA44><s0>0000</s0><s1>© 2014 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>24 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>14-0221022</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Transactions of the Royal Society of Tropical Medicine and Hygiene</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>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. 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Ansa</name></region><name sortKey="Siddiqi, Kamran" sort="Siddiqi, Kamran" uniqKey="Siddiqi K" first="Kamran" last="Siddiqi">Kamran Siddiqi</name><name sortKey="Walley, John D" sort="Walley, John D" uniqKey="Walley J" first="John D." last="Walley">John D. Walley</name><name sortKey="Xiaolin Wei" sort="Xiaolin Wei" uniqKey="Xiaolin Wei" last="Xiaolin Wei">XIAOLIN WEI</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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