Tuberculosis control activities in the private and public health sectors of Kenya from 2013 to 2017: how do they compare?
MetadataShow full item record
AbstractBACKGROUND: Large numbers of tuberculosis (TB) patients seek care from private for-profit providers. This study aimed to assess and compare TB control activities in the private for-profit and public sectors in Kenya between 2013 and 2017. METHODS: We conducted a retrospective cross-sectional study using routinely collected data from the National Tuberculosis, Leprosy and Lung Disease Program. RESULTS: Of 421 409 patients registered and treated between 2013 and 2017, 86 894 (21%) were from the private sector. Data collection was less complete in the private sector for nutritional assessment and follow-up sputum smear examinations (p<0.001). The private sector notified less bacteriologically confirmed TB (43.1% vs 52.6%; p<0.001) and had less malnutrition (body mass index <18.5 kg/m2; 36.4% vs 43.3%; p<0.001) than the public sector. Rates of human immunodeficiency virus (HIV) testing and antiretroviral therapy initiation were >95% and >90%, respectively, in both sectors, but more patients were HIV positive in the private sector (39.6% vs 31.6%; p<0.001). For bacteriologically confirmed pulmonary TB, cure rates were lower in the private sector, especially for HIV-negative patients (p<0.001). The private sector had an overall treatment success of 86.3% as compared with the public sector at 85.7% (p<0.001). CONCLUSIONS: The private sector is performing well in Kenya although there are programmatic challenges that need to be addressed.
PublisherOxford University Press
- Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.
- Authors: Hudson M, Rutherford GW, Weiser S, Fair E
- Issue date: 2018
- Comparing tuberculosis management under public and private healthcare providers: Victoria, Australia, 2002-2015.
- Authors: Dale KD, Tay EL, Trauer JM, Trevan PG, Denholm JT
- Issue date: 2017 May 3
- Public-private mix for control of tuberculosis and TB-HIV in Nairobi, Kenya: outcomes, opportunities and obstacles.
- Authors: Chakaya J, Uplekar M, Mansoer J, Kutwa A, Karanja G, Ombeka V, Muthama D, Kimuu P, Odhiambo J, Njiru H, Kibuga D, Sitienei J
- Issue date: 2008 Nov
- Tuberculosis services and treatment outcomes in private and public health care facilities in Thailand, 2004-2006.
- Authors: Chengsorn N, Bloss E, Anekvorapong R, Anuwatnonthakate A, Wattanaamornkiat W, Komsakorn S, Moolphate S, Limsomboon P, Kaewsa-ard S, Nateniyom S, Kanphukiew A, Varma JK
- Issue date: 2009 Jul
- Assessment of doctors' knowledge regarding tuberculosis management in Lucknow, India: a public-private sector comparison.
- Authors: Vandan N, Ali M, Prasad R, Kuroiwa C
- Issue date: 2009 Jul