Table 1.
Comparison of components of new and conventional care for HIV-infected TB patients in selected districts of Karnataka state, India between January and December 2016.
| Components | New care package | Conventional care |
|---|---|---|
| Screening for TB | Four symptom-based intensified screening at ART centre | Four symptom-based intensified screening at ART centre |
| Diagnosis of TB | Using CBNAAT and sputum microscopy facilitated by ART staff | Using CBNAAT and sputum microscopy facilitated by ART staff; Sputum samples were collected and transported to the nearest CBNAAT facility, wherever applicable |
| TB Treatment Initiation | Immediately after TB diagnosis at the ART centre | Patient referred from ART centre after diagnosis for treatment initiation at a Peripheral Health Institution (PHI), near to patient’s residence |
| Type of Drugs | Fixed-dose combination (FDC) of 4FDC during intensive phase and 3FDC during continuation phase. The number of pills per patient per day ranges from 2 to 5 based on weight band | No FDC available. Individual drugs with fixed-dose for all adults. The number of pills per patient (thrice weekly) ranged from 7 during intensive phase to 5 during continuation phase |
| Dosing frequency | Daily | Thrice weekly (alternate days) |
| Adherence support and compliance monitoring | Self-administered treatment with 99DOTS (Technology-enabled adherence support) | Directly Observed Treatment, usually provided by community health worker/volunteer of general health system |
| Drug dispensing | Dispensed for 28 days from the ART centre during their routine scheduled visit to centre | Dispensed thrice weekly during intensive phase and once weekly during continuation phase of treatment by the DOT provider at a place convenient to the patient |
| Patient Follow-up | ART centre | Peripheral Health Institution |
| Treatment outcome ascertainment | By the ART medical Officer | By the Medical officer of PHI |
Abbreviations: HIV- Human Immunodeficiency Virus; TB- Tuberculosis; ART- Antiretroviral Therapy; CBNAAT- Cartridge-Based Nuclei Acid Amplification Test; FDC- Fixed-Dose Combination; PHI- Peripheral Health Institution; DOT- Directly Observation Treatment