title: A rural public-private partnership model in tuberculosis control in south India.
abstract: METHODS
  A rural tuberculosis (TB) unit in South India, 2001-2003.
  
  
  OBJECTIVE
  To evaluate a rural public-private partnership model (PPPM) within the TB control programme (RNTCP).
  
  
  METHODS
  All of the private practitioners trained in modern medicine (PPs, n = 52) and the private laboratories (PLs, n = 13) in the area were listed. The PPs underwent training about the RNTCP, and PL staff were trained in sputum microscopy. PPPM included referral of TB suspects to the smear microscopy centres (government or PLs) for diagnosis and treatment of patients as per RNTCP guidelines. Patients were back-referred to the PPs. The directly observed treatment providers and centres were chosen by the PPs in consultation with their patients. The case detection rate, cure rate and profile of patients referred by the PPs were compared with those of self-reported patients.
  
  
  RESULTS
  Of 489 TB suspects referred by the PPs, 24% were smear-positive compared to 10% of 15 278 self-reported patients (P < 0.001). Of 319 referred to PLs, 7% were smear-positive. The annual average case detection rate increased from 66 to 75 per 100 000 population. The cure rates of patients referred by the PPs were comparable to those of self-reported patients.
  
  
  CONCLUSIONS
  This rural PPPM is effective and does not require additional staff or any direct financial incentives.
authors.affiliation: Tuberculosis Research Centre, Indian Council of Medical Research, Chennai, India.
authors.forename: R
authors.initials: R
authors.lastname: Balasubramanian
authors.forename: R
authors.initials: R
authors.lastname: Rajeswari
authors.forename: R D
authors.initials: RD
authors.lastname: Vijayabhaskara
authors.forename: K
authors.initials: K
authors.lastname: Jaggarajamma
authors.forename: P G
authors.initials: PG
authors.lastname: Gopi
authors.forename: V
authors.initials: V
authors.lastname: Chandrasekaran
authors.forename: P R
authors.initials: PR
authors.lastname: Narayanan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007194:India; D017053:Infection Control / Q000379:methods*; D016357:Infection Control Practitioners; D008297:Male; D008875:Middle Aged; D010317:Partnership Practice; D017149:Private Sector; D015397:Program Evaluation; D011634:Public Health; D019035:Rural Health Services; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000517:prevention & control*; D000078329:Workforce