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Table 2 Data collection tools, sources, and outcome measures

From: Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol

Data to be collected

Data source

Outcomes measure

TB-HIV integration indicators

 

 Clinical outcomes

TIER.Net, community care givers, autopsy reports

- Mortality rates—number of deaths among TB and HIV patients accessing care in study clinics from date clinic enrolled to 18 months post enrolment.

TIER.Net

- Proportion of patients retained in care—proportion of HIV-infected patients enrolled in care at clinics and alive 12 months.

TIER.Net

- Viral load testing coverage—proportion of patients on ART with viral loads test done among those eligible for viral load test at requested time points.

TIER.Net

- Viral load suppression—proportion of patients with undetectable viral load tests among those receiving 12 monthly viral load test.

TIER.Net and clinic TB registers

- TB treatment outcomes at end of study period—

- Cure rates: proportion of new smear-positive patients that are smear-negative in the last month of treatment and on at least one other occasion at least 30 days prior.

- Loss to follow-up rates: proportion of new smear-positive patients that interrupted TB treatment for 2 consecutive months or more.

- Treatment failure rates: Proportion of new smear-positive patients that are smear-positive at the end of TB treatment period.

- Death rate: proportion of new smear-positive patients that died during TB treatment.

- Transfer-out rate: proportion of new smear-positive pulmonary TB patients registered that were transferred to another district and for whom the TB treatment outcome is unknown.

 

 Process outcome

- HCT Coverage—proportion of patients with unknown HIV status tested for HIV

TIER.Net, DHIS and clinic-based registers

TIER.Net, DHIS and clinic-based registers

- Co-infection—proportion of TB patients co-infected with HIV

TIER.Net, DHIS and clinic-based registers

- Time to ART initiation (in days)—time in days between diagnosis of HIV infection diagnosis and ART initiation.

TIER.Net, DHIS and clinic-based registers

- TB screening coverage among HIV-infected patients—

a) Proportion of HIV-infected patients receiving TB screening and

b) Frequency of TB screening during follow-up

TIER.Net, DHIS and clinic-based registers

- IPT initiation—

a) Proportion of HIV-infected TB negative patients initiated on IPT and

b) Proportion of patients completing IPT course.

TIER.Net, DHIS and clinic-based registers

- CPT uptake among co-infected patients—proportion of eligible HIV-positive patients initiated on CPT

TB-HIV service integration in the facility macro-environment

Survey instrument developed by Uyei et al. 2014 [7]

Measured TB-HIV integration in terms of:

➢ Organization—such as co-location of services, combined patient records, information management, and joint training

➢ Structure—existent practice of joint service delivery,

➢ Process—behavior and practice of delivering services

➢ Culture—work place culture and personal identification with integrated service delivery

Clinic profile tool aimed at assessing clinics’ infrastructure, capacity, and systems in place to implement TB-HIV integration services

A CAPRISA designed tool

- Resources inventory and needs for implementation of TB-HIV integration services, e.g., available guidelines, protocols, policies, trained staff.

- Existing quality improvement interventions, processes and measurements

- District level leadership and support

Clinic culture, leadership, resources, etc.

The COACH tool designed by Bergstrom et al. 2015 [56]

- Clinic leadership and support

- Staff knowledge and skills

- Perceptions of work culture at PHC

Staff Work-related Quality of Life

WHO Work-related Quality of Life Scale

Work-related quality of life for staff at PHC