Tuberculosis at Chris Hani Baragwanath Hospital: an intervention to improve patient referrals to district clinics.
METHODS
A study in 2001 described the process of managing tuberculosis (TB) at Chris Hani Baragwanath hospital, the numbers of patients diagnosed and poor outcomes of referring patients to clinics in the adjacent sub-districts. The present study describes and evaluates an intervention to address the problems.


OBJECTIVE
To describe the intervention process (education and referral of TB patients) and the subsequent results over a 2-year period from 2003 to 2005.


METHODS
The process of establishing the system and how it was evaluated at district clinics in Johannesburg are described.


RESULTS
In the first 2 years of operation, August 2003 to July 2005, 13,138 patients were registered. Extra-pulmonary tuberculosis (EPTB) was diagnosed in 34%. Of the 46% tested for human immunodeficiency virus (HIV), 93% were positive. Successful referral to clinics was achieved for 94% of patients.


CONCLUSIONS
Very large numbers of patients are diagnosed with TB at Chris Hani Baragwanath Hospital. A TB care centre has successfully addressed important referral, education and registration requirements for the comprehensive management of TB with links to clinics. It is suggested that this model be applied at other hospitals.
Edginton
M E
ME
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. edgintonme@sph.wits.ac.za
Wong
M L
ML
Hodkinson
H J
HJ
D000293:Adolescent; D000328:Adult; D002648:Child; D006767:Hospitals, District; D006801:Humans; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013019:South Africa; D014376:Tuberculosis / Q000453:epidemiology / Q000628:therapy*