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