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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.