Effect of Public Sector Antiretroviral Treatment Programme on Tuberculosis and Immunization Care
Summary
A scale-up of public sector antiretroviral treatment (ART) programmes may divert scarce resources from other priority primary care programmes like tuberculosis and childhood immunization.
The purpose of this study is to compare the performance of tuberculosis (TB) and childhood immunization programmes in primary care facilities participating in the South African national antiretroviral treatment programme with those which have yet to be included in the ART programme.
Description
Large-scale public sector antiretroviral treatment programmes, like those planned for sub-Saharan Africa, will compete for scarce resources, in particular scarce human resources, with other priority primary care programmes like tuberculosis and childhood immunization.
This could lead to impaired performance in other priority programmes like childhood immunization while health workers are distracted by the demands of establishing and maintaining ART programmes. On the other hand, ART provisions may have positive spin-offs for related programmes like improved case detection of tuberculosis among HIV-positive patients seeking ART. The impact of the ART programme on primary healthcare more generally must be weighed against the benefits of providing antiretroviral treatment to those with AIDS.
Comparison: Primary care clinics in the Free State province, South Africa. 15 clinics participating in the first phases of the national ART programme will be compared with 24 clinics which have yet to be included in the national treatment programme. The unit of analysis will be the clinic although the outcome data will be collected from individual patients.
Study Design
Allocation: Non-Randomized, Control: Active Control, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Tuberculosis
Intervention
Public sector antiretroviral treatment programmes
Location
University of Cape Town Lung Institute
Cape Town
Western Cape
South Africa
7937
Status
Recruiting
Source
University of Cape Town
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00203762
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Public-private Sector Partnerships
An organizational enterprise between a public sector agency, federal, state or local, and a private sector entity. Skills and assets of each sector are shared to deliver a service or facility for the benefit or use of the general public.
Public Sector
The area of a nation's economy that is tax-supported and under government control.
Tuberculosis Societies
Voluntary agencies concerned with prevention and treatment of tuberculosis.
Latent Tuberculosis
The dormant form of TUBERCULOSIS where the person shows no obvious symptoms and no sign of the causative agent (Mycobacterium tuberculosis) in the SPUTUM despite being positive for tuberculosis infection skin test.
Health Care Sector
Economic sector concerned with the provision, distribution, and consumption of health care services and related products.
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