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Table 1 Key characteristics of each site

From: Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa

Model/Site PWP model PNP model Purely public model
  Site 1 (N = 95) Site 2 (N = 423) Site 3 (N = 355) Site 4 (N = 50) Site 5 (N = 85) Site 6 (N = 174)
Type of provision Private workplace Private workplace Private non-governmental Private non-governmental Public Public
Type of facility Occupational health clinic Occupational health clinic Clinic working closely with a local NGO Clinic working closely with a local NGO Health clinic Health clinic
Location (Province) Near large rural town in North West Near small rural town in Free State Urban informal settlement in Western Cape Rural informal settlement in Western Cape Small rural town in Western Cape Urban city area in Western Cape
Population served Low income workers, predominantly male Low income workers, predominantly male Low income residents, male and female adults, high unemployment Low income residents, male and female adults, high unemployment Low income residents, male and female adults, high unemployment Low income residents, male and female adults, high unemployment
TB incidence per 100 000 population* 1 073 3 012 439 149 169 176
Approximated HIV prevalence in the study population** (approx) 44% (approx) 48% (approx) 39% (approx) 36% (approx) 29% (approx) 23%
Overall TB service range Surveillance for TB, diagnosis and treatment Surveillance for TB, diagnosis and treatment Diagnosis, treatment, and social support Diagnosis, treatment, and social support Diagnosis and treatment Diagnosis and treatment
Case finding Annual radiological screening; passive, and contact tracing Annual radiological screening; passive, and contact tracing Passive Passive Passive Passive
Diagnosis Sputum smears; all patients with suspected pulmonary TB should have 1 sputum specimen submitted for culture Sputum smears; all patients with suspected pulmonary TB should have 1 sputum specimen submitted for culture Sputum smears; 1 sputum for culture if smear negative at diagnosis and unresponsive to a course of antibiotics Sputum smears; 1 sputum for culture if smear negative at diagnosis and unresponsive to a course of antibiotics Sputum smears; 1 sputum for culture if smear negative at diagnosis and unresponsive to a course of antibiotics Sputum smears; 1 sputum for culture if smear negative at diagnosis and unresponsive to a course of antibiotics
DOT system in place Hospitalisation for the first 7 days followed by DOT by nurses in the occupational clinics DOT by nurses in the occupational health clinics DOT by nurses in the public clinic for the first 10 days followed by DOT by 'treatment supporters' in the community DOT by nurses in the public clinic for the first 10 days followed by DOT by 'treatment supporters' in the community DOT by nurses in the public clinic DOT by nurses in the public clinic
  1. * Source for TB prevalence: providers' annual reports.
  2. ** Approximated by the clinic staff as no specific prevalence studies undertaken in clinic target populations. One of the reasons for higher HIV prevalence in sites 1 and 2 could be attributed to better case detection and follow-up in the PWP sites.
  3. Due to resource constraints, retrieval of defaulters is rarely done in the public sector. In the PNP model, if a patient does not attend, treatment supporters are expected to visit the patient's home within 24 hours and to report this to the public clinic.
  4. In the PWP model, compliance rate is extremely high mainly because of the system of 'parading' (a patient is not allowed to work if defaulting) which is in place in the mining companies where a patient has no choice but adhere to the treatment.