ArticleBMC health services research2023
Models of integration of TB and HIV services and factors associated with perceived quality of TB-HIV integrated service delivery in O. R Tambo District, South Africa.
Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mortality and predictors among HIV-TB co-infected patients in Ethiopia: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Time to treatment initiation in pregnant women with tuberculosis in Cape Town, South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Time to treatment initiation in pregnant women with tuberculosis in Cape Town, South Africa.PloS one · 2026Article
- Using interpretable decision trees to explore TB-HIV integration under data constraints: a proof-of-concept analysis.Frontiers in tuberculosis · 2026Article
- Overcoming Treatment Challenges in HIV-Associated Mycobacterial Diseases: New Therapeutic Frontiers.International journal of molecular sciences · 2025Review
- Access to tuberculosis care in South Africa during the COVID-19 pandemic: A scoping review.African journal of primary health care & family medicine · 2025Article
- Community-engaged clinical governance and machine learning for optimizing tuberculosis management in rural Eastern Cape.Frontiers in public health · 2025Article
- Healthcare workers' experiences with integrated HIV and TB prevention in Liangshan, China: a qualitative exploration of barriers and enablers.Frontiers in public health · 2025Article
- A mixed-methods study on healthcare workers' perceptions of treatment adherence among HIV-TB co-infected patients in a multi-disease prevention policy context.Frontiers in public health · 2025Article
- Developing a Model for Integrating of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in Oliver Reginald (O.R) Tambo District, Eastern Cape, South Africa.International journal of environmental research and public health · 2023Article
- Redefining HIV care: a path toward sustainability post-UNAIDS 95-95-95 targets.Frontiers in public health · 2023Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculosis is the leading infectious cause of death among people living with HIV. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care.
methodsThis is a qualitative study design using principles of ethnography and the application of aggregate complexity theory. A total of 54 individual interviews with healthcare workers and patients took place in five primary healthcare facilities in the O.R. Tambo district. The participants were purposively selected until the data reached saturation point, and all interviews were tape-recorded. Quantitative analysis of qualitative data was used after coding ethnographic data, looking for emerging patterns, and counting the number of times a qualitative code occurred. A Likert scale was used to assess the perceived quality of TB/HIV integration. Regression models and canonical discriminant analyses were used to explore the associations between the perceived quality of TB and HIV integrated service delivery and independent predictors of interest using SPSS® version 23.0 (Chicago, IL) considering a type I error of 0.05.
resultsOf the 54 participants, 39 (72.2%) reported that TB and HIV services were partially integrated while 15 (27.8%) participants reported that TB/HIV services were fully integrated. Using the Likert scale gradient, 23 (42.6%) participants perceived the quality of integrated TB/HIV services as poor while 13 (24.1%) and 18 (33.3%) perceived the quality of TB/HIV integrated services as moderate and excellent, respectively. Multiple linear regression analysis showed that access to healthcare services was significantly and independently associated with the perceived quality of integrated TB/HIV services following the equation: Y = 3.72-0.06X (adjusted R2 = 23%, p-value = 0.001). Canonical discriminant analysis (CDA) showed that in all 5 municipal facilities, long distances to healthcare facilities leading to reduced access to services were significantly more likely to be the most impeding factor, which is negatively influencing the perceived quality of integrated TB/HIV services, with functions' coefficients ranging from 9.175 in Mhlontlo to 16.514 in KSD (Wilk's Lambda = 0.750, p = 0.043).
conclusionHIV and TB integration is inadequate with limited access to healthcare services. Full integration (one-stop-shop services) is recommended.
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