title: Association between tuberculosis treatment outcomes and the mobile antiretroviral therapy programme in Zambia.
abstract: METHODS
  Free antiretroviral therapy (ART) services in Zambia were introduced in hospitals beginning in 2005 and in selected rural health centres (RHCs) beginning in 2007 through the mobile ART programme.
  
  
  OBJECTIVE
  To analyse the impact of scaling up ART services on tuberculosis (TB) treatment outcomes in Mumbwa District, Zambia.
  
  
  METHODS
  TB patients registered at all RHCs in the district between July 2006 and September 2009 were reviewed. RHCs were divided into two groups: 'ART sites', which provided ART services after 2007, and 'non-ART sites', which did not provide such services even after 2007. A before-after comparison analysis of TB patients was conducted between the groups.
  
  
  RESULTS
  A total of 732 patients were enrolled (median age 34.5 years; female 44.4%). The overall human immunodeficiency virus (HIV) testing rate was 72.3% and 66.7% of these patients were HIV-positive. The TB treatment success rate at the ART sites increased significantly compared to non-ART sites after the mobile ART programme was started (P < 0.01). The HIV testing acceptance rate also increased dramatically at ART sites, which facilitated intensified case finding (P = 0.02).
  
  
  CONCLUSIONS
  Scaling up ART services in rural health facilities through the mobile ART programme was found to be associated with greatly improved anti-tuberculosis treatment outcomes.
authors: Japan International Cooperation Agency, Zambia Office, Lusaka, Zambia. s-miyano@it.ncgm.go.jp
authors: S
authors: S
authors: Miyano
authors: C
authors: C
authors: Dube
authors: N
authors: N
authors: Kayama
authors: N
authors: N
authors: Ishikawa
authors: I
authors: I
authors: Nozaki
authors: G
authors: G
authors: Syakantu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006295:Health Resources; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D015397:Program Evaluation; D012042:Registries; D012189:Retrospective Studies; D019035:Rural Health Services; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents