Abstract
BACKGROUND: The World Health Organization (WHO) recommends active tuberculosis (TB) case finding among people living with human immunodeficiency virus (HIV) in resource-limited settings using a symptombased algorithm; those without active TB disease should be offered isoniazid preventive therapy (IPT). OBJECTIVE: To evaluate rates of adherence to WHO recommendations and the impact of a quality improvement intervention in an HIV clinic in Addis Ababa, Ethiopia. DESIGN: A prospective study design was utilized to compare TB symptom screening and IPT administration rates before and after a quality improvement intervention consisting of 1) educational sessions, 2) visual reminders, and 3) use of a screening checklist. RESULTS: A total of 751 HIV-infected patient visits were evaluated. The proportion of patients screened for TB symptoms increased from 22% at baseline to 94% following the intervention (P < 0.001). Screening rates improved from 51% to 81% (P < 0.001) for physicians and from 3% to 100% (P < 0.001) for nurses. Of the 281 patients with negative TB symptom screens and eligible for IPT, 4% were prescribed IPT before the intervention compared to 81% after (P < 0.001). CONCLUSIONS: We found that a quality improvement intervention significantly increased WHO-recommended TB screening rates and IPT administration. Utilizing nurses can help increase TB screening and IPT provision in resource-limited settings.
Original language | English (US) |
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Pages (from-to) | 1396-1401 |
Number of pages | 6 |
Journal | International Journal of Tuberculosis and Lung Disease |
Volume | 17 |
Issue number | 11 |
DOIs | |
State | Published - Nov 1 2013 |
Externally published | Yes |
Keywords
- Checklists
- Implementation science
- Quality improvement
- Task shifting
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Infectious Diseases