Publication: Evaluation of the Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data: Continuum of Care for Tuberculosis, Hypertension and Diabetes
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2018-07
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2019-04-01
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This report describes the findings of a study on the continua of care for tuberculosis, hypertension and diabetes in South Africa forming part of an evaluation of the National Adherence Guidelines for Chronic Diseases. Conducted by the National Department of Health in collaboration with the National Health Laboratory Service, the World Bank, and Boston University/Health Economics and Epidemiology Research Office, the study used routine data from 24 health facilities in Gauteng, KwaZulu-Natal, Limpopo, North West provinces. Observational cohorts of patients were created using clinic records and applying eligibility criteria. In the screening cohort of 3600 patients, 46 percent of eligible patients had a TB screen (83 percent of HIV patients) with 8 percent having positive screens. For hypertension, 72 of eligible patients were screened and 19 percent positive. For diabetes, 56 percent of eligible patients had evidence of screening in the past three years and 4 percent were positive. In the diagnosed cohort of 1,096 patients, treatment initiation was 98 percent for TB, 92 percent for hypertension and 82 percent for diabetes. Treatment success was 71 percent for TB, 22 percent for hypertension 18 percent for diabetes. The results demonstrated that considerable efforts are made to find cases and retain them in care, but that there is room for further improvement to maximize patient outcomes in chronic care.
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“World Bank Group. 2018. Evaluation of the Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data: Continuum of Care for Tuberculosis, Hypertension and Diabetes. © World Bank. http://hdl.handle.net/10986/31480 License: CC BY 3.0 IGO.”
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Publication Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data(World Bank, Washington, DC, 2016-10-31)This report describes enrollment into the cohorts for protocol 1 for the Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data. The study is evaluating short-term and long-term effects of five interventions being implemented by the National Department of Health (NDoH) in South Africa to improve adherence to HIV care and chronic disease care in general: Fast track initiation counselling, decentralized medicine delivery, adherence clubs, early patient tracing and enhanced adherence counselling. The study uses a randomized evaluation design to compare sites where the intervention was rolled out with control sites providing standard of care. 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