Improving tuberculosis diagnosis in South Africa’s private sector
The results of a pilot public-private mix intervention in eThekwini health district
Bibliographic Data
| ID | 19593486 |
|---|---|
| Authors | Jody Boffa (0000-0002-8183-6461, eThekwini Municipality), Tsholofelo Mhlaba (eThekwini Municipality), Buyisile Chibi (0000-0003-1912-8402, Human Sciences Research Council), Mergan Naidoo (0000-0002-4287-1168, eThekwini Municipality), Keeren Lutchminarain (0000-0002-0839-3369, eThekwini Municipality), Khine Swe Swe-Han (0000-0002-4574-6258, National Health Laboratory Service), Jeremiah Chikovore (0000-0002-4910-6952, Human Sciences Research Council), William Mapham (0000-0002-5151-9975, Cape Peninsula University of Technology), Sizulu Moyo (0000-0002-5296-3242, Human Sciences Research Council) |
| Editors | Giorgia Sulis (0000-0001-6641-0094) |
| Year | 2025 |
| Volume | 5 |
| Issue | 4 |
| Pages | e0004233 |
| Publication date | 2025-04-09 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | PLOS Global Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2767-3375 • E-ISSN: 2767-3375 |
| Publisher | Public Library of Science (PLoS) (PUBLISHER) |
| DOI | 10.1371/journal.pgph.0004233 |
| PMID | 40202991 |
| OpenAlex | W4409312353 |
| Language | EN |
| Citations received | 1 |
| References cited | 12 |
While tuberculosis (TB) is primarily addressed in South Africa’s public sector, people with TB also present to private sector General Practitioners (GPs), where TB may be missed or treatment delayed. We introduced a pilot project in a high-TB burden health district to connect private GPs to free public sector TB testing. We aimed to gauge GPs’ willingness to participate and describe TB patterns in the private sector. GPs practicing in metropolitan eThekwini from May 2021-March 2022 were invited to participate. Recruited GPs were provided sputum specimen jars, specimen transportation, and access to free TB testing through the National Health Laboratory Service for clients with TB-like symptoms. A customised electronic form on an established medical referral application (Vula) was developed to record client information, initiate specimen transport, share real-time test results, and communicate management guidance. Of the 313 eligible GPs, 158 (50.5%) agreed to participate, among whom 61 (38.6%) submitted at least one client specimen (median=6, IQR=2-12). Specimen yield (17.6%) and quality (99.7%) were high. One-hundred-seven clients were diagnosed with TB, 39.3% were female and 48.6% were living with HIV. Three clients (2.9%) were diagnosed with drug-resistant TB. One hundred people with TB (93.4%) were linked to treatment, 96.0% in the public sector, in an average of two days (IQR 1-5), with 88/100 completing treatment in a median 182 days (IQR=170-194). Two people with TB died before diagnosis by culture and six died during treatment, resulting in 7.5% case fatality (8/107). User-prompting to check HIV status significantly improved the frequency with which GPs enquired about HIV compared to a previous study (88.4% versus 25.7%, p
Economic growth · Family medicine · Private sector · Public health · Public sector · Referral · Tuberculosis · Chronic Disease Management Strategies · Medicine · Nursing · Pneumonia and Respiratory Infections · Tuberculosis Research and Epidemiology
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| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2025 - 2025 (1) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 1 |