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dc.contributor.authorMailu, EW
dc.contributor.authorOwiti, P
dc.contributor.authorAde, S
dc.contributor.authorHarries, AD
dc.contributor.authorManzi, M
dc.contributor.authorOmesa, E
dc.contributor.authorKiende, P
dc.contributor.authorMacharia, S
dc.contributor.authorMbithi, I
dc.contributor.authorKamene, M
dc.date.accessioned2019-08-20T16:29:50Z
dc.date.available2019-08-20T16:29:50Z
dc.date.issued2019-07-23
dc.date.submitted2019-08-15
dc.identifier.issn1878-3503
dc.identifier.pmid31334760
dc.identifier.doi10.1093/trstmh/trz062
dc.identifier.urihttp://hdl.handle.net/10144/619446
dc.description.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.en_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.rightsWith thanks to Oxford University Press.en_US
dc.subjectKenya
dc.subjectSORT-IT
dc.subjectoperational research
dc.subjectprivate–public mix
dc.subjecttuberculosis
dc.titleTuberculosis control activities in the private and public health sectors of Kenya from 2013 to 2017: how do they compare?en_US
dc.identifier.journalTransactions of the Royal Society of Tropical Medicineen_US
dc.source.journaltitleTransactions of the Royal Society of Tropical Medicine and Hygiene
refterms.dateFOA2019-08-20T16:29:50Z


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