Effects of financial incentives for treatment supporters on tuberculosis treatment outcomes in Swaziland: a pragmatic interventional study

Infectious Diseases of Poverty

John Wright³  John Walley⁷  Marty Richardson⁴  William Welfare⁸  Fred Busulwa¹  Sifiso Zwide Ndwandwe⁵  Mamvura Canaan⁶  Merav Kliner² 

[1] Good Shepherd Hospital, Siteki, Swaziland;Mersey Deanery, Summers Road, Liverpool L3 4BL, Merseyside, UK;Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK;Cochrane Infectious Diseases Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, Merseyside, UK;Family Life Association of Swaziland, Manzini, Swaziland;The Clinic Group, Matsapha Health Care, Manzini, Matsapha, Swaziland;Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK;Manchester Academic Health Science Centre, University of Manchester, Oxford Rd, Manchester M13 9PL, UK

关键词: Africa;    Swaziland;    Treatment success;    Tuberculosis;   

Others  :  1212353
DOI  :  10.1186/s40249-015-0059-8

 received in 2014-11-15, accepted in 2015-05-19,  发布年份 2015

【 摘 要 】

Background

Swaziland has the highest national incidence of tuberculosis (TB) in the world, with treatment success rates well below the 85 % international target. Treatment support as part of comprehensive TB services is a core component of the Stop TB Strategy. This study investigated the effects of financial incentives for treatment supporters on TB treatment outcomes in Swaziland.

Methods

This was a controlled study that compared treatment outcomes for patients with a treatment supporter who received or did not receive a financial incentive.

Results

The intervention group had a higher chance of treatment success as compared with the control group: 73 % (95 % confidence intervals [CIs] 66–80 %) versus 60 % (95 % CIs 57–64 %), respectively, p = 0.003. This improvement remained significant when treatment success rates were adjusted for differences in baseline characteristics, with the effect of incentivised treatment supporters on treatment outcomes having an odds ratio (OR) of 1.8. There was also a significant improvement in the death rate in the intervention group, as compared with the control group (10.6 versus 23.5 %, p = <0.001).

Conclusion

Incentives provided to TB treatment supporters appear to significantly improve TB treatment outcomes. Incentivising treatment support may be appropriate as an effective addition to support and supervision measures (199 words).

【 授权许可】

   
2015 Kliner et al.; licensee BioMed Central.

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