Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa

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dc.contributor.authorGovindasamy, Darshinien_ZA
dc.contributor.authorKranzer, Katharinaen_ZA
dc.contributor.authorvan Schaik, Nienkeen_ZA
dc.contributor.authorNoubary, Farzaden_ZA
dc.contributor.authorWood, Robinen_ZA
dc.contributor.authorWalensky, Rochelle Pen_ZA
dc.contributor.authorFreedberg, Kenneth Aen_ZA
dc.contributor.authorBassett, Ingrid Ven_ZA
dc.contributor.authorBekker, Linda-Gailen_ZA
dc.date.accessioned2015-11-23T12:25:45Z
dc.date.available2015-11-23T12:25:45Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: 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.en_ZA
dc.identifier.apacitationGovindasamy, D., Kranzer, K., van Schaik, N., Noubary, F., Wood, R., Walensky, R. P., ... Bekker, L. (2013). Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/15284en_ZA
dc.identifier.chicagocitationGovindasamy, Darshini, Katharina Kranzer, Nienke van Schaik, Farzad Noubary, Robin Wood, Rochelle P Walensky, Kenneth A Freedberg, Ingrid V Bassett, and Linda-Gail Bekker "Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15284en_ZA
dc.identifier.citationGovindasamy, D., Kranzer, K., van Schaik, N., Noubary, F., Wood, R., Walensky, R. P., ... & Bekker, L. G. (2012). Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa. PloS one, 8(11), e80017. doi:10.1371/journal.pone.0080017en_ZA
dc.identifier.ris TY - Journal Article AU - Govindasamy, Darshini AU - Kranzer, Katharina AU - van Schaik, Nienke AU - Noubary, Farzad AU - Wood, Robin AU - Walensky, Rochelle P AU - Freedberg, Kenneth A AU - Bassett, Ingrid V AU - Bekker, Linda-Gail AB - 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. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0080017 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa TI - Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa UR - http://hdl.handle.net/11427/15284 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15284
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0080017
dc.identifier.vancouvercitationGovindasamy D, Kranzer K, van Schaik N, Noubary F, Wood R, Walensky RP, et al. Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa. PLoS One. 2013; http://hdl.handle.net/11427/15284.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Govindasamy et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherDiabetes mellitusen_ZA
dc.subject.otherHypertensionen_ZA
dc.subject.otherHIV clinical manifestationsen_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.subject.otherHealth care facilitiesen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherTuberculosis diagnosis and managementen_ZA
dc.titleLinkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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