Evaluation of a nurse practitioner-physician task-sharing model for multidrug-resistant tuberculosis in South Africa

Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) in South Africa remain close to 50%. Lack of access to timely, decentralized care is a contributing factor. We evaluated MDR-TB treatment outcomes from a clinical cohort with task-sharing between a clinical nurse practitioner (CNP...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2017-08, Vol.12 (8), p.e0182780-e0182780
Main Authors: Farley, Jason E, Ndjeka, Norbert, Kelly, Ana M, Whitehouse, Erin, Lachman, Simmi, Budhathoki, Chakra, Lowensen, Kelly, Bergren, Ellie, Mabuza, Hloniphile, Mlandu, Ntombasekhaya, van der Walt, Martie
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
Analysis
Antibiotics
Biology and Life Sciences
Care and treatment
Decentralization
Drug resistance
Evaluation
Female
Human resources
Humans
Male
Medicine and Health Sciences
Multidrug resistance
Multidrug resistant organisms
Nurse Practitioners
Nurse-physician joint practice
Patient Care - methods
People and Places
Physicians
Practice
Safety
South Africa
Treatment Outcome
Tuberculosis
Tuberculosis, Multidrug-Resistant - drug therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) in South Africa remain close to 50%. Lack of access to timely, decentralized care is a contributing factor. We evaluated MDR-TB treatment outcomes from a clinical cohort with task-sharing between a clinical nurse practitioner (CNP) and a medical officer (MO). We completed a retrospective evaluation of outcomes from a prospective, programmatically-based MDR-TB cohort who were enrolled and received care between 2012 and 2015 at a peri-urban hospital in KwaZulu-Natal, South Africa. Treatment was provided by either by a CNP or MO. The cohort included 197 participants with a median age of 33 years, 51% female, and 74% co-infected with HIV. The CNP initiated 123 participants on treatment. Overall MDR-TB treatment success rate in this cohort was 57.9%, significantly higher than the South African national average of 45% in 2012 (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0182780