Assessing the impact of TB/HIV services integration on TB treatment outcomes and their relevance in TB/HIV monitoring in Ghana.
Identifieur interne : 000240 ( PubMed/Curation ); précédent : 000239; suivant : 000241Assessing the impact of TB/HIV services integration on TB treatment outcomes and their relevance in TB/HIV monitoring in Ghana.
Auteurs : Gloria Akosua Ansa [Ghana] ; John D. Walley ; Kamran Siddiqi ; Xiaolin WeiSource :
- Infectious diseases of poverty [ 2049-9957 ] ; 2012.
Abstract
The impact of the human immunodeficiency virus (HIV) on tuberculosis (TB), and the implications for TB and HIV control, is a public health challenge in Ghana - almost a quarter (23%) of all TB cases were HIV positive in 2010. The integration of TB/HIV services has therefore emerged as an essential component of the national response to TB and HIV. The aim is to reduce fragmentation, improve access, enhance efficiency and improve quality of care. Ghana's TB/HIV policy comprises three linked sets of activities: effective implementation of the Stop TB Strategy for TB control, improved HIV prevention and care, and the implementation of additional TB/HIV activities. Different models of service delivery with increasing integration of TB/HIV activities are expected to provide greater access to more comprehensive care. The objective of this paper is to assess the impact of TB/HIV integration on TB treatment outcomes and to explore the usefulness of TB treatment outcomes as TB/HIV indicators.
DOI: 10.1186/2049-9957-1-13
PubMed: 23849044
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Assessing the impact of TB/HIV services integration on TB treatment outcomes and their relevance in TB/HIV monitoring in Ghana.</title><author><name sortKey="Ansa, Gloria Akosua" sort="Ansa, Gloria Akosua" uniqKey="Ansa G" first="Gloria Akosua" last="Ansa">Gloria Akosua Ansa</name><affiliation wicri:level="1"><nlm:affiliation>University Hospital, Legon, University of Ghana, P, O, Box LG 79, Legon, Accra, Ghana. nana_akosua@yahoo.com.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>University Hospital, Legon, University of Ghana, P, O, Box LG 79, Legon, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Walley, John D" sort="Walley, John D" uniqKey="Walley J" first="John D" last="Walley">John D. Walley</name></author><author><name sortKey="Siddiqi, Kamran" sort="Siddiqi, Kamran" uniqKey="Siddiqi K" first="Kamran" last="Siddiqi">Kamran Siddiqi</name></author><author><name sortKey="Wei, Xiaolin" sort="Wei, Xiaolin" uniqKey="Wei X" first="Xiaolin" last="Wei">Xiaolin Wei</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="RBID">pubmed:23849044</idno><idno type="pmid">23849044</idno><idno type="doi">10.1186/2049-9957-1-13</idno><idno type="wicri:Area/PubMed/Corpus">000240</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000240</idno><idno type="wicri:Area/PubMed/Curation">000240</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000240</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Assessing the impact of TB/HIV services integration on TB treatment outcomes and their relevance in TB/HIV monitoring in Ghana.</title><author><name sortKey="Ansa, Gloria Akosua" sort="Ansa, Gloria Akosua" uniqKey="Ansa G" first="Gloria Akosua" last="Ansa">Gloria Akosua Ansa</name><affiliation wicri:level="1"><nlm:affiliation>University Hospital, Legon, University of Ghana, P, O, Box LG 79, Legon, Accra, Ghana. nana_akosua@yahoo.com.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>University Hospital, Legon, University of Ghana, P, O, Box LG 79, Legon, Accra</wicri:regionArea></affiliation></author><author><name sortKey="Walley, John D" sort="Walley, John D" uniqKey="Walley J" first="John D" last="Walley">John D. Walley</name></author><author><name sortKey="Siddiqi, Kamran" sort="Siddiqi, Kamran" uniqKey="Siddiqi K" first="Kamran" last="Siddiqi">Kamran Siddiqi</name></author><author><name sortKey="Wei, Xiaolin" sort="Wei, Xiaolin" uniqKey="Wei X" first="Xiaolin" last="Wei">Xiaolin Wei</name></author></analytic><series><title level="j">Infectious diseases of poverty</title><idno type="ISSN">2049-9957</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The impact of the human immunodeficiency virus (HIV) on tuberculosis (TB), and the implications for TB and HIV control, is a public health challenge in Ghana - almost a quarter (23%) of all TB cases were HIV positive in 2010. The integration of TB/HIV services has therefore emerged as an essential component of the national response to TB and HIV. The aim is to reduce fragmentation, improve access, enhance efficiency and improve quality of care. Ghana's TB/HIV policy comprises three linked sets of activities: effective implementation of the Stop TB Strategy for TB control, improved HIV prevention and care, and the implementation of additional TB/HIV activities. Different models of service delivery with increasing integration of TB/HIV activities are expected to provide greater access to more comprehensive care. The objective of this paper is to assess the impact of TB/HIV integration on TB treatment outcomes and to explore the usefulness of TB treatment outcomes as TB/HIV indicators.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">23849044</PMID><DateCreated><Year>2013</Year><Month>07</Month><Day>15</Day></DateCreated><DateCompleted><Year>2013</Year><Month>07</Month><Day>15</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Print">2049-9957</ISSN><JournalIssue CitedMedium="Print"><Volume>1</Volume><Issue>1</Issue><PubDate><Year>2012</Year><Month>Dec</Month><Day>24</Day></PubDate></JournalIssue><Title>Infectious diseases of poverty</Title><ISOAbbreviation>Infect Dis Poverty</ISOAbbreviation></Journal><ArticleTitle>Assessing the impact of TB/HIV services integration on TB treatment outcomes and their relevance in TB/HIV monitoring in Ghana.</ArticleTitle><Pagination><MedlinePgn>13</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/2049-9957-1-13</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The impact of the human immunodeficiency virus (HIV) on tuberculosis (TB), and the implications for TB and HIV control, is a public health challenge in Ghana - almost a quarter (23%) of all TB cases were HIV positive in 2010. The integration of TB/HIV services has therefore emerged as an essential component of the national response to TB and HIV. The aim is to reduce fragmentation, improve access, enhance efficiency and improve quality of care. Ghana's TB/HIV policy comprises three linked sets of activities: effective implementation of the Stop TB Strategy for TB control, improved HIV prevention and care, and the implementation of additional TB/HIV activities. Different models of service delivery with increasing integration of TB/HIV activities are expected to provide greater access to more comprehensive care. The objective of this paper is to assess the impact of TB/HIV integration on TB treatment outcomes and to explore the usefulness of TB treatment outcomes as TB/HIV indicators.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A before-and-after study to observe the introduction of TB/HIV activities into TB programmes in three hospitals with different levels of integration was conducted. Anonymised patient data was collated from TB registers from each facility, and analysed to determine if TB treatment outcomes changed significantly after integration.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">TB treatment success was 50% (95% CI 49 - 52) prior to, and 69% (95% CI 65 - 73) after, integration (Χ2 43.96, p < 0.00). Treatment success increased from 43% to 53% at the one-stop shop (OSS), from 69% to 78% at the partially integrated site (PIS) and substantially from 46% to 78% at the referral site (RS) (Χ2 64.54; p<0.01). Defaults and cases transferred out reduced from 14.3% and 15.3% prior to integration, to 1.4% and 9.0% after integration, respectively, accounting for a significant increase in treatment success. Death rates remained high at 18% in all cases studied and 25% in HIV-associated cases after integration.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">TB/HIV integration may improve TB treatment success, but its exact impact is difficult to ascertain due to non-specificity and design limitations. TB mortality may be more useful as an indicator for monitoring TB/HIV activities in Ghana.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ansa</LastName><ForeName>Gloria Akosua</ForeName><Initials>GA</Initials><AffiliationInfo><Affiliation>University Hospital, Legon, University of Ghana, P, O, Box LG 79, Legon, Accra, Ghana. nana_akosua@yahoo.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walley</LastName><ForeName>John D</ForeName><Initials>JD</Initials></Author><Author ValidYN="Y"><LastName>Siddiqi</LastName><ForeName>Kamran</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Wei</LastName><ForeName>Xiaolin</ForeName><Initials>X</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>12</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Infect Dis Poverty</MedlineTA><NlmUniqueID>101606645</NlmUniqueID><ISSNLinking>2049-9957</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Healthc Q. 2009;13 Spec No:6-15</RefSource><PMID Version="1">20057243</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Health Policy. 2003 Aug;65(2):139-51</RefSource><PMID Version="1">12849913</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet Infect Dis. 2006 Aug;6(8):483-95</RefSource><PMID Version="1">16870527</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Integr Care. 2005;5:e01; discussion e03, e09</RefSource><PMID Version="1">16773158</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Qual Health Care. 2003 Dec;15(6):523-30</RefSource><PMID Version="1">14660535</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Tuberc Lung Dis. 2003 Sep;7(9 Suppl 1):S92-8</RefSource><PMID Version="1">12971660</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2009 Jan 1;50(1):37-43</RefSource><PMID Version="1">19295333</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Tuberc Lung Dis. 2005 Feb;9(2):123-7</RefSource><PMID Version="1">15732729</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Tuberc Lung Dis. 2010 May;14(5):611-5</RefSource><PMID Version="1">20392355</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Health Plann Manage. 2006 Jan-Mar;21(1):75-88</RefSource><PMID Version="1">16604850</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Trans R Soc Trop Med Hyg. 1995 Jan-Feb;89(1):78-82</RefSource><PMID Version="1">7747316</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2006 Mar 18;367(9514):926-37</RefSource><PMID Version="1">16546541</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Milbank Q. 1999;77(1):77-110, iv-v</RefSource><PMID Version="1">10197028</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Milbank Q. 2007;85(1):93-138</RefSource><PMID Version="1">17319808</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Trans R Soc Trop Med Hyg. 2007 Sep;101(9):893-8</RefSource><PMID Version="1">17597174</PMID></CommentsCorrections></CommentsCorrectionsList><OtherID Source="NLM">PMC3710204</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2012</Year><Month>10</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2012</Year><Month>12</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>7</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2012</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2012</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23849044</ArticleId><ArticleId IdType="pii">2049-9957-1-13</ArticleId><ArticleId IdType="doi">10.1186/2049-9957-1-13</ArticleId><ArticleId IdType="pmc">PMC3710204</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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