Association between tuberculosis treatment outcomes and the mobile antiretroviral therapy programme in Zambia
Abstract:SETTING: Free antiretroviral therapy (ART) services in Zambia were introduced in hospitals beginning in 2005 and in selected rural health centres (RHCs) beginning in 2007 through the mobile ART programme.
OBJECTIVE: To analyse the impact of scaling up ART services on tuberculosis (TB) treatment outcomes in Mumbwa District, Zambia.
DESIGN: TB patients registered at all RHCs in the district between July 2006 and September 2009 were reviewed. RHCs were divided into two groups: ‘ART sites’, which provided ART services after 2007, and ‘non-ART sites’, which did not provide such services even after 2007. A before-after comparison analysis of TB patients was conducted between the groups.
RESULTS: A total of 732 patients were enrolled (median age 34.5 years; female 44.4%). The overall human immunodeficiency virus (HIV) testing rate was 72.3% and 66.7% of these patients were HIV-positive. The TB treatment success rate at the ART sites increased significantly compared to non-ART sites after the mobile ART programme was started (P < 0.01). The HIV testing acceptance rate also increased dramatically at ART sites, which facilitated intensified case finding (P = 0.02).
CONCLUSION: Scaling up ART services in rural health facilities through the mobile ART programme was found to be associated with greatly improved anti-tuberculosis treatment outcomes.
Document Type: Research Article
Affiliations: 1: Japan International Cooperation Agency, Zambia Office, Lusaka, Zambia; and National Center for Global Health and Medicine, Tokyo, Japan 2: Mumbwa District Medical Office, Mumbwa, Zambia 3: Department of Clinical Care and Diagnostic Services, Ministry of Health, Lusaka, Zambia
Publication date: April 1, 2013
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