ArticleInternational journal of environmental research and public health2018
Measuring Quality Gaps in TB Screening in South Africa Using Standardised Patient Analysis.
Article in International journal of environmental research and public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments.BMJ global health · 2021Pooled it
- How to do (or not to do) … using the standardized patient method to measure clinical quality of care in LMIC health facilities.Health policy and planning · 2019Pooled it
- Effect of tuberculosis screening and retention interventions on early antiretroviral therapy mortality in Botswana: a stepped-wedge cluster randomized trial.BMC medicine · 2020Trial
- Towards ending tuberculosis in South Africa: an uncertainty analysis of the programmes and factors most critical to future declines.Global health action · 2026Article
- Evaluating the implementation of the vignettes-based injury care process assessment tool in low- and middle-income countries settings.BMC health services research · 2026Article
- Development and validation of a machine learning model for community-based tuberculosis screening among persons aged ≥ 15 years in South Africa and Zambia.medRxiv : the preprint server for health sciences · 2026Article
- Using Unannounced Standardized Patients to Assess the Quality of Tuberculosis Care and Antibiotic Prescribing: A Cross-Sectional Study on a Low/Middle-Income Country, Pakistan.Antibiotics (Basel, Switzerland) · 2025Article
- Improving tuberculosis diagnosis in South Africa's private sector: The results of a pilot public-private mix intervention in eThekwini health district.PLOS global public health · 2025Article
- Provider perspectives on empirical antibiotic treatment for tuberculosis-like symptoms in South Africa's private general practice sector: A qualitative study in two cities.PLOS global public health · 2025Article
- Article
- Point-of-care C-reactive protein and Xpert MTB/RIF Ultra for tuberculosis screening and diagnosis in unselected antiretroviral therapy initiators: a prospective, cross-sectional, diagnostic accuracy study.The Lancet. Global health · 2024Article
- Quality of TB diagnostic services at primary healthcare clinics in eThekwini district, South Africa.PloS one · 2024Article
- Health system assessment for access to care after injury in low- or middle-income countries: A mixed methods study from Northern Malawi.PLoS medicine · 2024Article
- Missed opportunity for tuberculosis screening among patients presenting at two health facilities in Manafwa district, Uganda.Journal of public health in Africa · 2023Article
- Dispensing of antibiotics for tuberculosis patients using standardized patient approach at community pharmacies: results from a cross-sectional study in Pakistan.Frontiers in public health · 2023Article
- Prevalence of Mycobacterium tuberculosis in Sputum and Reported Symptoms Among Clinic Attendees Compared With a Community Survey in Rural South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Undernotification and underreporting of tuberculosis in Zambia: a national data quality assessment.BMC health services research · 2022Article
- Improving Data Surveillance Resilience Beyond COVID-19: Experiences of Primary heAlth Care quAlity Cohort In ChinA (ACACIA) Using Unannounced Standardized Patients.American journal of public health · 2022Article
- Baseline study for improving diagnostic stewardship at secondary health care facilities in Nigeria.Antimicrobial resistance and infection control · 2022Article
- Missed opportunities for diagnosis and treatment in patients with TB symptoms: a systematic review.Public health action · 2022Review
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed. Only 43% of interactions resulted in SPs receiving a TB sputum test and being offered an HIV test. TB sputum tests were conducted routinely (84%) while HIV tests were offered less frequently (47%). Nurses frequently neglected to ask SPs whether their household contacts had confirmed TB (54%). Antibiotics were prescribed without taking temperatures in 8% of cases. The importance of returning to the facility to receive TB test results was only explained in 28%. The SP method has highlighted gaps in clinical practice, signalling missed opportunities. Early detection of sub-optimal TB care is instrumental in decreasing TB-related morbidity and mortality. The findings provide the rationale for further quality improvement work in TB management.
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