Table of Contents
ISRN Public Health
Volume 2014, Article ID 623690, 10 pages
http://dx.doi.org/10.1155/2014/623690
Research Article

Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study

1Department of Paediatrics, University of Padua, Via Giustiniani 3, 35128 Padua, Italy
2Home Care Department, Saint Raphael of Saint Francis Hospital (Nsambya Hospital), Kampala, Uganda
3Infectious Diseases Research Collaboration, Mulago Hospital Complex, Kampala, Uganda
4Saint Raphael of Saint Francis Hospital (Nsambya Hospital), Kampala, Uganda
5Santa Chiara Hospital, Via Largo Gold Medals 9, 38122 Trento, Italy
6Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
7Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda
8MRC/UVRI Uganda Research Unit on AIDS, Plot 51-59, Nakiwogo Road, Entebbe, Uganda

Received 30 November 2013; Accepted 8 January 2014; Published 6 March 2014

Academic Editors: C. M. Buchalla and R. E. Fullilove

Copyright © 2014 William Massavon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes.