Govindasamy, Darshini; Kranzer, Katharina; van Schaik, Nienke; Noubary, Farzad; Wood, Robin; Walensky, Rochelle P; Freedberg, Kenneth A; Bassett, Ingrid V; Bekker, Linda-Gail; (2013) Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa. PloS one, 8 (11). e80017-. ISSN 1932-6203 DOI: https://doi.org/10.1371/journal.pone.0080017
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Abstract
BACKGROUND: HIV counseling and testing may serve as an entry point for non-communicable disease screening. OBJECTIVES: To determine the yield of newly-diagnosed HIV, tuberculosis (TB) symptoms, diabetes and hypertension, and to assess CD4 count testing, linkage to care as well as correlates of linkage and barriers to care from a mobile testing unit. METHODS: A mobile unit provided screening for HIV, TB symptoms, diabetes and hypertension in Cape Town, South Africa between March 2010 and September 2011. The yield of newly-diagnosed cases of these conditions was measured and clients were followed-up between January and November 2011 to assess linkage. Linkage to care was defined as accessing care within one, three or six months post-HIV diagnosis (dependent on CD4 count) and one month post-diagnosis for other conditions. Clinical and socio-demographic correlates of linkage to care were evaluated using Poisson regression and barriers to care were determined. RESULTS: Of 9,806 clients screened, the yield of new diagnoses was: HIV (5.5%), TB suspects (10.1%), diabetes (0.8%) and hypertension (58.1%). Linkage to care for HIV-infected clients, TB suspects, diabetics and hypertensives was: 51.3%, 56.7%, 74.1% and 50.0%. Only disclosure of HIV-positive status to family members or partners (RR=2.6, 95% CI: 1.04-6.3, p=0.04) was independently associated with linkage to HIV care. The main barrier to care reported by all groups was lack of time to access a clinic. CONCLUSION: Screening for HIV, TB symptoms and hypertension at mobile units in South Africa has a high yield but inadequate linkage. After-hours and weekend clinics may overcome a major barrier to accessing care.
Item Type | Article |
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Faculty and Department |
Faculty of Public Health and Policy > Dept of Global Health and Development Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
PubMed ID | 24236170 |
ISI | 327254700171 |
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