Improving tuberculosis control through public-private collaboration in India: literature review

Dewan, Puneet; Lal, S S; Lönnroth, Knut; Wares, Fraser; Uplekar, Mukund; Sahu, Suvanand; Granich, Reuben; Ls, Chauhan

doi:10.1136/bmj.38738.473252.7c

Cited by 124 publications

(141 citation statements)

References 5 publications

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“…In addition, patients come from remote areas and usually do not come again once their condition improves after a few months of treatment. Our study also supported previous studies showing that the private sector not only contributed to case finding, but also maintain good treatment outcomes [10][11][12].…”

Section: Discussionsupporting

confidence: 81%

Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan

Chughtai

Qadeer

Khan³

et al. 2013

East Mediterr Health J

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To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37 656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects. 1National TB Control Programme, Islamabad, Pakistan (Correspondence to A.A. Chughtai: doctorahmad75@gmail.com

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Section: Discussionsupporting

confidence: 81%

Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan

Chughtai

Qadeer

Khan³

et al. 2013

East Mediterr Health J

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“…14 However another study in India showed no significant different in the out come of treatment between the public and private health facilities. 15 The overall treatment success of 81.3% compares favorably with both the Kaduna State and national figures of 80.4% and 81.0% respectively. Similar to a study in India, this study found higher treatment success rates among patients managed by the private sector.…”

Section: Discussionsupporting

confidence: 56%

Tuberculosis case management and treatment outcome: Assessment of the effectiveness of public - private mix of tuberculosis programme in Kaduna state, Nigeria

Gidado¹,

Ejembi

2009

Ann Afr Med

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Background:In an effort to increase tuberculosis (TB) case detection, the Kaduna State TB program in Nigeria started Public-Private Mix (PPM DOTS) in 2002. This study assessed and compared the TB case management practices and treatment outcomes of the public and private health facilities involved in the TB program. Methods: A comparative cross-sectional descriptive study was carried out in 5 private and 10 public health facilities providing TB services for at least two years in the four Local Governments Areas in Kaduna State where both public and private health facilities are involved in the TB program. The heads of the health facilities were interviewed and case notes of all the 492 TB patients registered in these facilities between January 2003 and December 2004 reviewed. Results: Except for the lower use of sputum microscopy for diagnosis, adherence to national TB treatment guidelines was high in both private and public health facilities. The private health facilities significantly saw more TB patients, an average of 51 patients per health facility compared to 23 patients in the public health facilities. There was better completion of records in the public health facilities while patient contact screening was very low in both public and private health facilities, 13.1% and 12.2% respectively. The treatment success rate was higher among patients managed in the private health facilities (83.7%) compared to 78.6% in the public health facilities. Conclusion: Private health facilities adhere to national guidelines had higher TB patient case load and better treatment outcome than public health facilities in Kaduna State. PPM-DOTS should be scaled-up and consolidated.

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“…The uncertainty surrounding incidence estimates provides a small chance that the true value was higher than 70%, but this is unlikely given that many patients are not found by passive case detection under DOTS. [20][21][22] Nonetheless, TB burden and trends have not been accurately measured in many countries; for example, in eastern and southern African countries, it is not clear whether increases in case notifications reflect higher case detection rates or a real increase in incidence linked to the spread of HIV. We suggest that new methods for evaluating case detection and incidence are needed, based principally on assessments of the quality of surveillance systems, backed by data obtained from surveys of the prevalence of infection or active disease.…”

Section: Resultsmentioning

confidence: 99%

Did we reach the 2005 targets for tuberculosis control?

Dye

Hosseini

Watt

2007

Bull World Health Organ

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TB incidence rates are rarely measured directly in longitudinal studies; therefore, incidence is estimated from population-based, cross-sectional surveys of the prevalence of Mycobacterium tuberculosis infection or TB disease, or from independent assessments (often qualitative) of the performance of surveillance systems. 13,14 The essential formulae for calculating incidence are:The available data differ from country to country, and not all methods can be applied in every country; in particular, Abstract The World Health Assembly set targets to detect by 2005 at least 70% of all new sputum smear-positive cases arising each year and to cure at least 85% of these cases. The national tuberculosis (TB) control programmes of 199 countries reported that in 2005, 2.3 million new smear-positive cases were diagnosed under WHO's DOTS strategy, out of an estimated 3.9 million (95% confidence limit (CL) 3.4 million to 4.4 million) new smear-positive cases arising in that year, a global case detection rate of 60% (95% CL 52% to 69%). Of 2.1 million new smear-positive patients registered for treatment in 2004, 84% had successful outcomes. Of the regions, only the WHO Western Pacific Region reached both targets, with case detection and treatment success rates of 76% and 91%, respectively; South-East Asia reached the treatment success target with a rate of 87%. In relation to countries, WHO estimates that 67 achieved the target detection rates and 57 achieved the target for treatment success, with 26 -including high-burden countries China, the Philippines and Viet Nam -achieving both targets. DOTS programmes diagnosed more than 26 million patients (all forms of TB) in 1995-2005. Building on this success, the Global Plan to Stop TB 2006-2015, describes the actions needed to implement WHO's new Stop TB Strategy over the coming decade to reduce TB incidence, prevalence and deaths in line with the Millennium Development Goals.

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Improving tuberculosis control through public-private collaboration in India: literature review

Cited by 124 publications

References 5 publications

Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan

Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan

Tuberculosis case management and treatment outcome: Assessment of the effectiveness of public - private mix of tuberculosis programme in Kaduna state, Nigeria

Did we reach the 2005 targets for tuberculosis control?

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