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dc.contributor.authorHuerga, H*
dc.contributor.authorSpillane, H*
dc.contributor.authorGuerrero, W*
dc.contributor.authorOdongo, A*
dc.contributor.authorVaraine, F*
dc.date.accessioned2010-10-29T14:28:57Z
dc.date.available2010-10-29T14:28:57Z
dc.date.issued2010-04-09
dc.date.submitted2010-10-08
dc.identifier.citationInt J Tuberc Lung Dis 2010;14(5):611-5en
dc.identifier.issn1815-7920
dc.identifier.pmid20392355
dc.identifier.urihttp://hdl.handle.net/10144/114127
dc.description.abstractSETTING: In July 2005, Médecins Sans Frontières and the Ministry of Health, Kenya, implemented an integrated tuberculosis-human immunodeficiency virus (TB-HIV) programme in western Kenya. OBJECTIVE: To evaluate the impact of an integrated TB-HIV programme on patient care and TB programme outcomes. DESIGN: Retrospective evaluation of three time periods: before (January-June 2005), shortly after (January-June 2006) and medium term after (January-December 2007) the implementation of the integrated programme. RESULTS: Respectively 79% and 91% of TB patients were HIV tested shortly and at medium term after service integration. The HIV-positive rate varied from 96% before the intervention to respectively 88% (305/347) and 74% (301/405) after. The estimated number of HIV-positive cases was respectively 303, 323 and 331 in the three periods. The proportion of patients receiving cotrimoxazole prophylaxis increased significantly from 47% (142/303) to 94% (303/323) and 86% (285/331, P < 0.05). Before the intervention, 87% (171/197) of the TB-HIV patients would have been missed when initiating antiretroviral treatment, compared to respectively 29% (60/210) and 36% (78/215) after the integration. The TB programme success rate increased from 56% (230/409) to 71% (319/447) in the third period (P < 0.05); however, there was no significant decrease in the default rate: 20% to 22% (P = 0.66) and 18% (P = 0.37). CONCLUSION: Integrated TB-HIV care has a very positive impact on the management of TB-HIV patients and on TB treatment outcomes.
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/20392355en
dc.rightsArchived with thanks to The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshAnti-Infective Agentsen
dc.subject.meshDelivery of Health Care, Integrateden
dc.subject.meshHIV Infectionsen
dc.subject.meshKenyaen
dc.subject.meshPatient Careen
dc.subject.meshRetrospective Studiesen
dc.subject.meshRural Health Servicesen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTrimethoprim-Sulfamethoxazole Combinationen
dc.subject.meshTuberculosisen
dc.titleImpact of introducing human immunodeficiency virus testing, treatment and care in a tuberculosis clinic in rural Kenyaen
dc.typeArticleen
dc.contributor.departmentMédecins Sans Frontières, Nairobi, Kenya; National Tuberculosis Programme, Homa Bay, Kenya; Médecins Sans Frontières, Paris, Franceen
dc.identifier.journalInternational Journal of Tuberculosis and Lung Diseaseen
refterms.dateFOA2019-03-04T08:24:19Z
html.description.abstractSETTING: In July 2005, Médecins Sans Frontières and the Ministry of Health, Kenya, implemented an integrated tuberculosis-human immunodeficiency virus (TB-HIV) programme in western Kenya. OBJECTIVE: To evaluate the impact of an integrated TB-HIV programme on patient care and TB programme outcomes. DESIGN: Retrospective evaluation of three time periods: before (January-June 2005), shortly after (January-June 2006) and medium term after (January-December 2007) the implementation of the integrated programme. RESULTS: Respectively 79% and 91% of TB patients were HIV tested shortly and at medium term after service integration. The HIV-positive rate varied from 96% before the intervention to respectively 88% (305/347) and 74% (301/405) after. The estimated number of HIV-positive cases was respectively 303, 323 and 331 in the three periods. The proportion of patients receiving cotrimoxazole prophylaxis increased significantly from 47% (142/303) to 94% (303/323) and 86% (285/331, P < 0.05). Before the intervention, 87% (171/197) of the TB-HIV patients would have been missed when initiating antiretroviral treatment, compared to respectively 29% (60/210) and 36% (78/215) after the integration. The TB programme success rate increased from 56% (230/409) to 71% (319/447) in the third period (P < 0.05); however, there was no significant decrease in the default rate: 20% to 22% (P = 0.66) and 18% (P = 0.37). CONCLUSION: Integrated TB-HIV care has a very positive impact on the management of TB-HIV patients and on TB treatment outcomes.


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