M Clarke1, J Dick, M Zwarenstein, C J Lombard, V K Diwan. 1. Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Stockholm, Sweden. Marina.Clarke@phs.ki.se
Abstract
SETTING:Farms in the Boland health district, Western Cape Province, South Africa. OBJECTIVE: To evaluate the effect of lay health workers (LHWs) on tuberculosis (TB) control among permanent farm workers and farm dwellers in an area with particularly high TB prevalence. DESIGN: Pragmatic, unblinded cluster randomised control trial. METHODS: This trial measured successful treatment completion rates among new smear-positive (NSP) adult TB patients on 106 intervention farms, and compared them with outcomes in patients on 105 control farms. Farms were the unit of randomisation, and analysis was by intention to treat. RESULTS: A total of 164 adult TB patients were recruited into the study, 89 of whom were NSP. The successful treatment completion rate in NSP adult TB patients was 18.7% higher (P = 0.042, 95%CI 0.9-36.4) on farms in the intervention group than on farms in the control group. Case finding for adult NSP TB cases was 8% higher (P = 0.2671) on farms in the intervention group compared to the control group. CONCLUSION: Trained LHWs were able to improve the successful TB treatment rate among adult NSP TB patients in a well-established health service, despite reduction of services.
RCT Entities:
SETTING: Farms in the Boland health district, Western Cape Province, South Africa. OBJECTIVE: To evaluate the effect of lay health workers (LHWs) on tuberculosis (TB) control among permanent farm workers and farm dwellers in an area with particularly high TB prevalence. DESIGN: Pragmatic, unblinded cluster randomised control trial. METHODS: This trial measured successful treatment completion rates among new smear-positive (NSP) adult TB patients on 106 intervention farms, and compared them with outcomes in patients on 105 control farms. Farms were the unit of randomisation, and analysis was by intention to treat. RESULTS: A total of 164 adult TB patients were recruited into the study, 89 of whom were NSP. The successful treatment completion rate in NSP adult TB patients was 18.7% higher (P = 0.042, 95%CI 0.9-36.4) on farms in the intervention group than on farms in the control group. Case finding for adult NSP TB cases was 8% higher (P = 0.2671) on farms in the intervention group compared to the control group. CONCLUSION: Trained LHWs were able to improve the successful TB treatment rate among adult NSP TB patients in a well-established health service, despite reduction of services.
Authors: Jean B Nachega; Richard E Chaisson; Rene Goliath; Anne Efron; Mohammad A Chaudhary; Malathi Ram; Chelsea Morroni; Hennie Schoeman; Amy R Knowlton; Gary Maartens Journal: AIDS Date: 2010-06-01 Impact factor: 4.177
Authors: Simon Lewin; Susan Munabi-Babigumira; Claire Glenton; Karen Daniels; Xavier Bosch-Capblanch; Brian E van Wyk; Jan Odgaard-Jensen; Marit Johansen; Godwin N Aja; Merrick Zwarenstein; Inger B Scheel Journal: Cochrane Database Syst Rev Date: 2010-03-17
Authors: Sarah Wood Pallas; Dilpreet Minhas; Rafael Pérez-Escamilla; Lauren Taylor; Leslie Curry; Elizabeth H Bradley Journal: Am J Public Health Date: 2013-05-16 Impact factor: 9.308
Authors: Cynthia R Pearson; Mark Micek; Jane M Simoni; Eduardo Matediana; Diane P Martin; Stephen Gloyd Journal: J Acquir Immune Defic Syndr Date: 2006-12-01 Impact factor: 3.731
Authors: Alyssa Finlay; Joey Lancaster; Timothy H Holtz; Karin Weyer; Abe Miranda; Martie van der Walt Journal: BMC Public Health Date: 2012-01-20 Impact factor: 3.295