Trial reportTrials2013
Economic support to improve tuberculosis treatment outcomes in South Africa: a pragmatic cluster-randomized controlled trial.
Trial report in Trials, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 7 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- A meta-analysis of technology-based interventions on treatment adherence and treatment success among TBC patients.PloS one · 2024Pooled it
- Interventions to improve medication adherence in tuberculosis patients: a systematic review of randomized controlled studies.NPJ primary care respiratory medicine · 2020Pooled it
- Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies.PLoS medicine · 2018Pooled it
- Nutritional supplements for people being treated for active tuberculosis.The Cochrane database of systematic reviews · 2016Pooled it
- Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis- a systematic review of global literature with focus on South Africa.Health and quality of life outcomes · 2016Pooled it
- Pooled it
- Incentives and enablers to improve adherence in tuberculosis.The Cochrane database of systematic reviews · 2015Pooled it
- A randomized controlled study of socioeconomic support to enhance tuberculosis prevention and treatment, Peru.Bulletin of the World Health Organization · 2017Trial
- Trial
- Article
- Delays in tuberculosis care among the top-ten-tuberculosis-high burden countries in the world: a scoping review.The Journal of the Egyptian Public Health Association · 2026Review
- Patient-centred interventions for drug-resistant tuberculosis: A scoping review.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Transport stipend to facilitate cancer early detection: experiences of beneficiaries and perspectives of program personnel in Rwanda.BMC public health · 2025Article
- Alabama Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (AL-SIGHT): The Impact of Financial Incentives on Health Care Engagement Following Telemedicine-Based Vision Screening.Current eye research · 2025Article
- Implementing active surveillance for tuberculosis: A quality improvement project.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Evaluation of health-related quality of life and adherence among pre-extensively drug-resistant tuberculosis patients receiving either Bedaquiline or Delamanid regimen at a teaching hospital in Eastern India.Journal of family medicine and primary care · 2024Article
- Estimation of potential social support requirement for tuberculosis patients in India.Health policy and planning · 2024Article
- Cash transfers to enhance completion of TB screening among household contacts in rural Tanzania.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2024Article
- Low treatment success rate among previously treated persons with drug-susceptible pulmonary tuberculosis in Kampala, Uganda.Journal of clinical tuberculosis and other mycobacterial diseases · 2023Article
- Social Protection Interventions for TB-Affected Households: A Scoping Review.The American journal of tropical medicine and hygiene · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundPoverty undermines adherence to tuberculosis treatment. Economic support may both encourage and enable patients to complete treatment. In South Africa, which carries a high burden of tuberculosis, such support may improve the currently poor outcomes of patients on tuberculosis treatment. The aim of this study was to test the feasibility and effectiveness of delivering economic support to patients with pulmonary tuberculosis in a high-burden province of South Africa.
methodsThis was a pragmatic, unblinded, two-arm cluster-randomized controlled trial, where 20 public sector clinics acted as clusters. Patients with pulmonary tuberculosis in intervention clinics (n = 2,107) were offered a monthly voucher of ZAR120.00 (approximately US$15) until the completion of their treatment. Vouchers were redeemed at local shops for foodstuffs. Patients in control clinics (n = 1,984) received usual tuberculosis care.
resultsIntention to treat analysis showed a small but non-significant improvement in treatment success rates in intervention clinics (intervention 76.2%; control 70.7%; risk difference 5.6% (95% confidence interval: -1.2%, 12.3%), P = 0.107). Low fidelity to the intervention meant that 36.2% of eligible patients did not receive a voucher at all, 32.3% received a voucher for between one and three months and 31.5% received a voucher for four to eight months of treatment. There was a strong dose-response relationship between frequency of receipt of the voucher and treatment success (P <0.001).
conclusionsOur pragmatic trial has shown that, in the real world setting of public sector clinics in South Africa, economic support to patients with tuberculosis does not significantly improve outcomes on treatment. However, the low fidelity to the delivery of our voucher meant that a third of eligible patients did not receive it. Among patients in intervention clinics who received the voucher at least once, treatment success rates were significantly improved. Further operational research is needed to explore how best to ensure the consistent and appropriate delivery of such support to those eligible to receive it.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.