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Open AccessArticle

An Innovative Public–Private Mix Model for Improving Tuberculosis Care in Vietnam: How Well are We Doing?

1
Vietnam Integrated Center for Tuberculosis and Respirology Research, Vietnam National Lung Hospital, Vietnam Tuberculosis Control Programme, Hanoi, Vietnam
2
International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
3
International Union Against Tuberculosis and Lung Disease, Paris, France
4
Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, India
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National Centre of Excellence and Advanced Research on Anemia Control, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
6
International Union Against Tuberculosis and Lung Disease, Mandalay, Myanmar
7
Friends for International Tuberculosis Relief, Ho Chi Minh City, Vietnam
8
Stop TB Partnership, Geneva, Switzerland
9
Haiphong International General Hospital, Haiphong, Vietnam
10
Hanoi Medical University, Hanoi, Vietnam
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2020, 5(1), 26; https://doi.org/10.3390/tropicalmed5010026
Received: 14 November 2019 / Revised: 23 December 2019 / Accepted: 10 February 2020 / Published: 14 February 2020
To improve tuberculosis (TB) care among individuals attending a private tertiary care hospital in Vietnam, an innovative private sector engagement model was implemented from June to December 2018. This included: (i) Active facility-based screening of all adults for TB symptoms (and chest x-ray (CXR) for those with symptoms) by trained and incentivized providers, with on-site diagnostic testing or transport of sputum samples, (ii) a mobile application to reduce dropout in the care cascade and (iii) enhanced follow-up care by community health workers. We conducted a cohort study using project and routine surveillance data for evaluation. Among 52,078 attendees, 368 (0.7%) had symptoms suggestive of TB and abnormalities on CXR. Among them, 299 (81%) were tested and 103 (34.4%) were diagnosed with TB. In addition, 195 individuals with normal CXR were indicated for TB testing by attending clinicians, of whom, seven were diagnosed with TB. Of the 110 TB patients diagnosed, 104 (95%) were initiated on treatment and 97 (93%) had a successful treatment outcome. Given the success of this model, the National TB Programme is considering to scale it up nationwide after undertaking a detailed cost-effectiveness analysis.
Keywords: public–private mix model; public–private partnership; missing cases; operational research; SORT IT public–private mix model; public–private partnership; missing cases; operational research; SORT IT
MDPI and ACS Style

Thu, T.D.; Kumar, A.M.; Ramaswamy, G.; Htun, T.; Van, H.L.; Quang, L.V.N.; Thu, T.D.T.; Codlin, A.; Forse, R.; Crewsell, J.; Thanh, H.N.; Viet, H.N.; Van, H.B.; Binh, H.N.; Viet, N.N. An Innovative Public–Private Mix Model for Improving Tuberculosis Care in Vietnam: How Well are We Doing? Trop. Med. Infect. Dis. 2020, 5, 26.

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