Public-private mix for improved TB control in Ho Chi Minh City, Vietnam: an assessment of its impact on case detection.
METHODS
Ho Chi Minh City (HCMC), Vietnam.


OBJECTIVE
To assess the impact on case detection of a public-private mix (PPM) project linking private providers (PPs) to the National Tuberculosis Programme (NTP).


METHODS
Nine-month monitoring of referral and diagnostic data recorded in new referral forms and treatment cards for PPs and upgraded NTP registers.


RESULTS
A total of 1549 TB suspects were referred, of whom 1090 (70%) actually went to the NTP for sputum examination. A total of 569 cases were detected through referrals or notification, of whom 45% were new sputum smear-positive cases. The case detection of new sputum smear-positive cases in PPM districts increased by 18% (21/100,000, 95%CI 0-42) compared to the previous year, while a slight decrease occurred in control districts. In HCMC as a whole, case detection increased by 7% (7/100,000, 95%CI 2-11/100,000). Among sputum smear-positive cases detected in NTP through referrals from PPs, 58% defaulted before initiating treatment.


CONCLUSIONS
The tendency towards increased case detection associated with this PPM indicates a potential for utilising PPs to improve case detection. However, the NTP and PPs should jointly address the problem of initial default before considering expansion of this PPM model.
Quy
H T
HT
Pham Ngoc Thach TB and Lung Disease Center, Ho Chi Minh City, Vietnam.
Lan
N T N
NT
Lönnroth
K
K
Buu
T N
TN
Dieu
T T N
TT
Hai
L T
LT
D018563:Disease Notification; D006801:Humans; D011331:Private Practice; D012017:Referral and Consultation; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000517:prevention & control*; D014744:Vietnam