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dc.contributor.authorAnanthakrishnan, Ramya
dc.contributor.authorRichardson, M D'Arcy
dc.contributor.authorvan den Hof, Susan
dc.contributor.authorRangaswamy, Radha
dc.contributor.authorThiagesan, Rajeswaran
dc.contributor.authorAuguesteen, Sheela
dc.contributor.authorKamp, Netty
dc.date.accessioned2019-04-26T07:58:14Z
dc.date.available2019-04-26T07:58:14Z
dc.date.issued2019-03-22
dc.identifier.issn2169-575X
dc.identifier.pmid30926737
dc.identifier.doi10.9745/GHSP-D-18-00318
dc.identifier.urihttp://hdl.handle.net/10029/623033
dc.description.abstractPrivate physicians in India see and treat more than half of all people with tuberculosis (TB) each year and thus have potential to make significant contributions to TB control. The EQUIP project was designed as a prospective cohort study to assess the potential of private providers to diagnose and appropriately treat drug-resistant TB (DR-TB) in the Central and South districts of Chennai, India. The private-sector engagement model consisted of free access to rapid diagnostics; choice of free daily or thrice-weekly treatment regimens; support for notification of patients; and patient support including directly observed therapy through EQUIP centers staffed by a community-based interface agency. Data were collected on provider participation; referral results; treatment regimens prescribed; and treatment outcomes. From October 2015 through June 2017, 227 of the 466 (48.7%) private providers approached referred at least 1 patient to an EQUIP center for evaluation. A total of 2,621 patients received testing and 1,232 (47.0%) were diagnosed with TB. Of those, 727 (59.0%) were bacteriologically confirmed, including 694 (56.3%) using GeneXpert and 33 (2.7%) using smear microscopy. A total of 26 (3.7% of GeneXpert diagnosed) patients were confirmed as rifampicin-resistant cases. EQUIP-related notifications comprised approximately 10% of TB and DR-TB notifications in Chennai during the project period. The project initiated 1,167 (96.8%) drug-sensitive TB patients on treatment. Of those, 691 (59.2%) received standard daily regimens with EQUIP support and 288 (24.7%) received standard intermittent regimens. At the time of writing, 89.4% of 868 drug-susceptible TB patients receiving EQUIP support had treatment success. Of the 26 rifampicin-resistant TB cases notified, 20 (77%) started and continued on second-line treatment; 2 died and 4 were lost to follow-up prior to treatment initiation. Private providers can make a substantial contribution to detection and appropriate treatment of patients with TB and DR-TB in India when provided with access to rapid diagnostics, support for notification and patient treatment through interface agencies, and free, quality anti-TB drugs.en_US
dc.language.isoenen_US
dc.titleSuccessfully Engaging Private Providers to Improve Diagnosis, Notification, and Treatment of TB and Drug-Resistant TB: The EQUIP Public-Private Model in Chennai, India.en_US
dc.typeArticleen_US
dc.identifier.journalGlob Health Sci Pract 2019; 7(1):41-53en_US
dc.source.journaltitleGlobal health, science and practice


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