Treatment results among tuberculosis patients treated by private lung specialists involved in a public-private mix project in Vietnam.
METHODS
Ho Chi Minh City, Vietnam.


OBJECTIVE
To determine treatment outcome among patients treated by private lung specialists in a public-private mix (PPM) project for improved TB control.


METHODS
Cohorts of patients treated by private lung specialists within the PPM project and in National Tuberculosis Programme (NTP) facilities were followed for up to 12 months. The quality of case management and treatment outcome was determined based on information in treatment cards. As a complement, questionnaire surveys of private providers (PPs) and patients and focus group discussions with PPs were conducted.


RESULTS
Among 400 patients treated by PPs, 36 different treatment regimens were used. Directly observed treatment was not used at all, and treatment evaluation with sputum smear microscopy and health education was inadequate. Overall treatment success was 60% and the default rate was 37%, which was considerably worse than in NTP facilities.


CONCLUSIONS
This PPM project, which used a combination of training, supervision, standardised referral and information system and financial incentives, did not achieve sufficiently good treatment outcome by PPs. Possible reasons for the poor outcome include absence of subsidisation of drug costs and lack of regulatory enforcement.
Quy
H T
HT
Pham Ngoc Thach TB and Lung Disease Hospital, Ho Chi Minh City, Vietnam.
Lönnroth
K
K
Lan
N T N
NT
Buu
T N
TN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003906:Developing Countries; D023801:Directly Observed Therapy / Q000592:standards / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000592:standards / Q000639:trends; D017063:Outcome Assessment, Health Care; D011331:Private Practice; D011336:Probability; D017150:Public Sector; D016019:Survival Analysis; D016896:Treatment Outcome; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D014744:Vietnam
D000995:Antitubercular Agents