Evidence map›Paper›PMID 38627799›Full record

ArticleImplementation science communications2024

Systems analysis and improvement approach to optimize tuberculosis (SAIA-TB) screening, treatment, and prevention in South Africa: a stepped-wedge cluster randomized trial.

Brittney J van de Water, Meredith B Brooks, Refiloe Matji, Betty Ncanywa, Freck Dikgale, Nadia N Abuelezam, Bulelwa Mzileni, Miyakazi Nokwe, Singilizwe Moko, Lindiwe Mvusi and 2 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Implementation science communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06314386 (SAIA-TB), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
5.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT06314386 naenrolling by invitationnot on this mapstarted 2025, after this paper: background citation

SAIA-TB: Using the Systems Analysis and Improvement Approach (SAIA) to Prevent TB in Rural South Africa

TypeinterventionalSponsorBoston CollegeRan2025 to 2029Enrolled19,560ConditionsTuberculosis, TPT, TB - TuberculosisArmsSystems Analysis and Improvement Approach for TB (SAIA-TB)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Brittney J van de WaterConnell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA. brittney.vandewater@bc.edu.ORCID http://orcid.org/0000-0002-0476-6295
Meredith B BrooksSchool of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA.
Refiloe MatjiAQUITY Innovations, 114 Sovereign Drive, Centurion, South Africa.
Betty NcanywaAQUITY Innovations, Greenacres Park, Gqeberha, South Africa.
Freck DikgaleAQUITY Innovations, 114 Sovereign Drive, Centurion, South Africa.
Nadia N AbuelezamConnell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
Bulelwa MzileniDepartment of Health, Sarah Baartman District, 16 Grace Street, Gqeberha, South Africa.
Miyakazi NokweDepartment of Health, Eastern Cape, Dukumbana Building, Bisho, South Africa.
Singilizwe MokoDepartment of Health, Eastern Cape, Dukumbana Building, Bisho, South Africa.
Lindiwe MvusiNational Department of Health, 1112 Voortrekker Road, Pretoria, South Africa.
Marian LovedayHIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, South Africa.
Sarah GimbelDepartment of Child, University of Washington, Family & Population Health Nursing, Gerberding HallSeattle, WA, 98195, USA.
Boston College · USEducation Labour Relations Council · ZAWestern Cape Department of Health · ZABoston University · USDepartment of Health · ZASouth African Medical Research Council · ZAUniversity of Washington · US

Funding

SAIA-TB: Using the Systems Analysis and Improvement Approach (SAIA) to prevent TB in rural South AfricaR01NR020866 · NINR · BOSTON COLLEGE · PI Brittney Jayne van de Water · 2023 to 2026
$2.5M
NINR NIH HHS R01 NR020866NINR NIH HHS R01NR020866
6 · The paper itself

Abstract

backgroundThe use of systems engineering tools, including the development and use of care cascades using routinely collected data, process mapping, and continuous quality improvement, is used for frontline healthcare workers to devise systems level change. South Africa experiences high rates of tuberculosis (TB) infection and disease as well as HIV co-infection. The Department of Health has made significant gains in HIV services over the last two decades, reaching their set "90-90-90" targets for HIV. However, TB services, although robust, have lagged in comparison for both disease and infection. The Systems Analysis and Improvement Approach (SAIA) is a five-step implementation science method, drawn from systems engineering, to identify, define, and implement workflow modifications using cascade analysis, process mapping, and repeated quality improvement cycles within healthcare facilities.

methodsThis stepped-wedge cluster randomized trial will evaluate the effectiveness of SAIA on TB (SAIA-TB) cascade optimization for patients with TB and high-risk contacts across 16 clinics in four local municipalities in the Sarah Baartman district, Eastern Cape, South Africa. We hypothesize that SAIA-TB implementation will lead to a 20% increase in each of: TB screening, TB preventive treatment initiation, and TB disease treatment initiation during the 18-month intervention period. Focus group discussions and key informant interviews with clinic staff will also be conducted to determine drivers of implementation variability across clinics. DISCUSSION: This study has the potential to improve TB screening, treatment initiation, and completion for both active disease and preventive measures among individuals with and without HIV in a high burden setting. SAIA-TB provides frontline health care workers with a systems-level view of their care delivery system with the aim of sustainable systems-level improvements.

trial registrationClinicaltrials.gov, NCT06314386. Registered 18 March 2024, https://clinicaltrials.gov/study/NCT06314386 . NCT06314386.

Indexed as

Capacity buildingImplementation scienceInfectious diseaseSub-Saharan Africa

Identifiers

PMID38627799
PMCPMC11021007
OpenAlexW4394845605

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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.