Linkage & Retention: A Randomized Trial to Optimize HIV/TB Care in South Africa
连锁
基本信息
- 批准号:7838990
- 负责人:
- 金额:$ 58.6万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2010
- 资助国家:美国
- 起止时间:2010-05-01 至 2015-01-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAffectAfrica South of the SaharaAfricanBehavioralBehavioral SciencesBiometryCD4 Lymphocyte CountCaringCause of DeathCessation of lifeCollaborationsCritical CareDataDeath RateDiagnosisDiagnostic ServicesDiseaseEarly DiagnosisEffectiveness of InterventionsEnrollmentEpidemicFailureFundingGap JunctionsGovernmentHIVHIV diagnosisHealth systemHealthcareHigh PrevalenceHuman immunodeficiency virus testImmunologicsImprove AccessIndividualInterventionLeadLifeLinkMedicalMentored Patient-Oriented Research Career Development AwardModelingNewly DiagnosedOutcomeOutcome AssessmentOutpatientsPatientsPhysiciansPolicy MakerPositioning AttributeProvinceQuality of CareRandomized Controlled TrialsResearchResearch InfrastructureResearch PersonnelResourcesRisk BehaviorsScreening procedureSouth AfricaTarget PopulationsTestingTimeTuberculosisWorkantiretroviral therapyattributable mortalitybaseclinical epidemiologycostcost effectivenessfollow-uphealth care service utilizationimprovedmortalitynovelpandemic diseaseprogramspublic health relevancerandomized trialresponsesocialstandard of caretreatment programtuberculosis treatment
项目摘要
DESCRIPTION (provided by applicant): The benefits of antiretroviral therapy (ART) can only be achieved through timely HIV diagnosis, successful linkage to care, and treatment initiation. In South Africa, however, only a fraction of those newly diagnosed with HIV enter HIV care. The period after HIV testing but prior to ART initiation represents a time of very high mortality, fueled by the tuberculosis (TB) epidemic, and therefore a time when improving access to TB screening and HIV care would be of substantial benefit. Though TB is the leading cause death among those with HIV in sub-Saharan Africa, less than one-third of HIV-infected South Africans have been screened for TB. Efforts are urgently needed to implement and evaluate strategies that improve early diagnosis and linkage to HIV and TB care, and to consider such strategies in the context of constrained healthcare resources. We propose two specific aims. The first aim is to conduct a randomized controlled trial to establish the efficacy of a health system navigator intervention in improving linkage to HIV and TB care among newly diagnosed HIV-infected outpatients in Durban, South Africa. Using Andersen's model of health service utilization as a theoretical framework, we will provide a health system navigator to help patients identify and overcome barriers to care and we will examine the intersection of contextual and patient-level factors that affect linkage to care. The second aim is to evaluate the cost and cost-effectiveness of this intervention for promoting linkage to HIV and TB care at the time of HIV screening. The 2010 Trans-NIH Plan for HIV-related research prioritizes the assessment of outcomes related to TB and HIV care integration on survival, quality of care, and cost, as well as the impact of different approaches for testing, linkage, and retention in care in improving outcomes of HIV disease. The proposed study will address several of these important issues through collaboration among medical, behavioral and cost- effectiveness experts working in the US and the South African province with the highest prevalence of HIV and TB. The results will inform HIV and TB care in South Africa and in other resource-limited settings.
PUBLIC HEALTH RELEVANCE: The period after a new HIV diagnosis, but prior to starting antiretroviral therapy, is a time of very high mortality for patients in South Africa, and therefore a time when improving access to HIV care would be of substantial benefit. We propose to study the impact and cost-effectiveness of an intervention to improve linkage to HIV and TB care for newly diagnosed HIV-infected people in Durban, South Africa.
描述(由申请人提供):抗逆转录病毒治疗(ART)的好处只能通过及时的艾滋病毒诊断,成功的联系到护理和治疗开始实现。然而,在南非,只有一小部分新诊断的艾滋病毒感染者进入艾滋病毒护理。艾滋病毒检测后但开始抗逆转录病毒治疗前的这段时间是死亡率非常高的时期,结核病(TB)的流行助长了这一时期,因此,在这段时间里,改善结核病筛查和艾滋病毒护理的可及性将产生重大益处。虽然结核病是撒哈拉以南非洲艾滋病毒感染者的主要死因,但只有不到三分之一的艾滋病毒感染者接受了结核病筛查。迫切需要努力实施和评估改善早期诊断和与艾滋病毒和结核病护理联系的战略,并在医疗资源有限的情况下考虑这些战略。我们提出两个具体目标。第一个目标是进行一项随机对照试验,以确定卫生系统导航干预措施在南非德班新诊断的艾滋病毒感染门诊患者中改善与艾滋病毒和结核病护理联系的有效性。使用安德森的卫生服务利用模型作为理论框架,我们将提供一个卫生系统导航,以帮助患者识别和克服障碍,以照顾,我们将研究的背景和患者层面的因素,影响联系到护理的交叉点。第二个目标是评估这种干预措施的成本和成本效益,以促进在艾滋病毒筛查时与艾滋病毒和结核病护理的联系。2010年跨NIH艾滋病毒相关研究计划优先评估结核病和艾滋病毒护理整合对生存率、护理质量和成本的影响,以及不同的检测、联系和保留护理方法对改善艾滋病毒疾病结局的影响。这项拟议中的研究将通过在美国和南非艾滋病毒和结核病流行率最高的省份工作的医疗、行为和成本效益专家之间的合作,解决其中几个重要问题。研究结果将为南非和其他资源有限环境中的艾滋病毒和结核病护理提供信息。
公共卫生关系:在南非,新的艾滋病毒诊断后但在开始抗逆转录病毒治疗之前的时期是患者死亡率非常高的时期,因此,在这一时期,改善获得艾滋病毒护理的机会将产生重大效益。我们建议研究干预措施的影响和成本效益,以改善南非德班新诊断的艾滋病毒感染者与艾滋病毒和结核病护理的联系。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Ingrid Valerie Bassett其他文献
Ingrid Valerie Bassett的其他文献
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{{ truncateString('Ingrid Valerie Bassett', 18)}}的其他基金
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
9889026 - 财政年份:2019
- 资助金额:
$ 58.6万 - 项目类别:
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
9790038 - 财政年份:2019
- 资助金额:
$ 58.6万 - 项目类别:
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
10338169 - 财政年份:2019
- 资助金额:
$ 58.6万 - 项目类别:
Mentoring in patient-oriented research on HIV and global health
指导以患者为中心的艾滋病毒和全球健康研究
- 批准号:
10570265 - 财政年份:2019
- 资助金额:
$ 58.6万 - 项目类别:
South Africa's new Central Chronic Medicine Dispensing and Distribution program: assessing the clinic, patient, and community impact
南非新的中央慢性药物配发和分配计划:评估诊所、患者和社区的影响
- 批准号:
10194606 - 财政年份:2018
- 资助金额:
$ 58.6万 - 项目类别:
South Africa's new Central Chronic Medicine Dispensing and Distribution program: assessing the clinic, patient, and community impact
南非新的中央慢性药物配发和分配计划:评估诊所、患者和社区的影响
- 批准号:
10413904 - 财政年份:2018
- 资助金额:
$ 58.6万 - 项目类别:
South Africa's new Central Chronic Medicine Dispensing and Distribution program: assessing the clinic, patient, and community impact
南非新的中央慢性药物配发和分配计划:评估诊所、患者和社区的影响
- 批准号:
9751392 - 财政年份:2018
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$ 58.6万 - 项目类别:
What happens after diagnosis: Characterizing long-term HIV care trajectories and mortality in South Africa
诊断后会发生什么:描述南非长期艾滋病毒护理轨迹和死亡率
- 批准号:
9140315 - 财政年份:2016
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$ 58.6万 - 项目类别:
Test and Treat TB: A Proof of Concept Trial in South Africa
测试和治疗结核病:南非的概念验证试验
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8739080 - 财政年份:2014
- 资助金额:
$ 58.6万 - 项目类别:
Test and Treat TB: A Proof of Concept Trial in South Africa
测试和治疗结核病:南非的概念验证试验
- 批准号:
8887097 - 财政年份:2014
- 资助金额:
$ 58.6万 - 项目类别:
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