Samson Kironde1, Martha Kahirimbanyi. 1. Medical Research Council, P.O. Box 2388, Kimberley 8300, South Africa. skironde@hotmail.com
Abstract
BACKGROUND: Currently, there is renewed interest in the role community participation can play in Primary Health Care (PHC) programmes such as the delivery of effective anti-TB treatment to patients in high-burden settings. OBJECTIVES: To explore the feasibility of community participation in a high-burden Tuberculosis Control Programme and to establish how supervision of treatment by lay volunteers compares with other methods of tuberculosis treatment delivery in the Northern Cape province of South Africa. METHODS: Prospective study involving 769 patients with confirmed pulmonary TB who were followed-up over a one-year period. Questionnaire interviews were also carried out with 135 lay volunteers participating in the TB programme. RESULTS: One-third of the TB patients in the study received their treatment from lay volunteers in the community. Treatment outcomes for new patients supervised from the community were found to be equivalent to those who received treatment through other modes of treatment delivery (RR=1.04[0.94-1.16], p=0.435). For the re-treatment patients, community-based treatment was found to be superior (RR=5.89[2.30-15.09], p<0.001), to self-administered therapy. CONCLUSIONS: Health care planners should consider community participation as a viable way of ensuring accessibility and effectiveness in PHC programmes. There is need for more research into ways of achieving sustainability in resource-limited but high disease burden settings.
BACKGROUND: Currently, there is renewed interest in the role community participation can play in Primary Health Care (PHC) programmes such as the delivery of effective anti-TB treatment to patients in high-burden settings. OBJECTIVES: To explore the feasibility of community participation in a high-burden Tuberculosis Control Programme and to establish how supervision of treatment by lay volunteers compares with other methods of tuberculosis treatment delivery in the Northern Cape province of South Africa. METHODS: Prospective study involving 769 patients with confirmed pulmonary TB who were followed-up over a one-year period. Questionnaire interviews were also carried out with 135 lay volunteers participating in the TB programme. RESULTS: One-third of the TBpatients in the study received their treatment from lay volunteers in the community. Treatment outcomes for new patients supervised from the community were found to be equivalent to those who received treatment through other modes of treatment delivery (RR=1.04[0.94-1.16], p=0.435). For the re-treatment patients, community-based treatment was found to be superior (RR=5.89[2.30-15.09], p<0.001), to self-administered therapy. CONCLUSIONS: Health care planners should consider community participation as a viable way of ensuring accessibility and effectiveness in PHC programmes. There is need for more research into ways of achieving sustainability in resource-limited but high disease burden settings.
Authors: Peter Makaula; Paul Bloch; Hastings T Banda; Grace Bongololo Mbera; Charles Mangani; Alexandra de Sousa; Edwin Nkhono; Samuel Jemu; Adamson S Muula Journal: BMC Health Serv Res Date: 2012-09-20 Impact factor: 2.655
Authors: Evelyn Sakeah; Lois McCloskey; Judith Bernstein; Kojo Yeboah-Antwi; Samuel Mills; Henry V Doctor Journal: BMC Health Serv Res Date: 2014-08-11 Impact factor: 2.655
Authors: Ahmed Arshad; Rehana A Salam; Zohra S Lassi; Jai K Das; Imama Naqvi; Zulfiqar A Bhutta Journal: Infect Dis Poverty Date: 2014-08-01 Impact factor: 4.520
Authors: Narcis Kabatereine; Fiona Fleming; Wangechi Thuo; Benjamin Tinkitina; Edridah M Tukahebwa; Alan Fenwick Journal: BMC Res Notes Date: 2014-12-11