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Free Content Public-private mix for improved TB control in Ho Chi Minh City, Vietnam: an assessment of its impact on case detection

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Abstract:

SETTING: Ho Chi Minh City (HCMC), Vietnam.

OBJECTIVE: To assess the impact on case detection of a public-private mix (PPM) project linking private providers (PPs) to the National Tuberculosis Programme (NTP).

METHOD: Nine-month monitoring of referral and diagnostic data recorded in new referral forms and treatment cards for PPs and upgraded NTP registers.

RESULTS: A total of 1549 TB suspects were referred, of whom 1090 (70%) actually went to the NTP for sputum examination. A total of 569 cases were detected through referrals or notification, of whom 45% were new sputum smear-positive cases. The case detection of new sputum smear-positive cases in PPM districts increased by 18% (21/100000, 95%CI 0–42) compared to the previous year, while a slight decrease occurred in control districts. In HCMC as a whole, case detection increased by 7% (7/100000, 95%CI 2–11/100000). Among sputum smear-positive cases detected in NTP through referrals from PPs, 58% defaulted before initiating treatment.

CONCLUSIONS: The tendency towards increased case detection associated with this PPM indicates a potential for utilising PPs to improve case detection. However, the NTP and PPs should jointly address the problem of initial default before considering expansion of this PPM model.

Keywords: case detection; private health care; public-private mix; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Pham Ngoc Thach TB and Lung Disease Center, Ho Chi Minh City, Vietnam 2: Department of Social Medicine, Göteborg University, Göteborg, Sweden; and Nordic School of Public Health, Göteborg, Sweden

Publication date: 2003-05-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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