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Integrating childhood TB: applying the care delivery value chain to improve pediatric HIV/TB services in Togo, West Africa
Journal article   Open access   Peer reviewed

Integrating childhood TB: applying the care delivery value chain to improve pediatric HIV/TB services in Togo, West Africa

Melanie Dubois, Elissa Z. Faro, Diana S. Lee, Venance Katin, Komlan Kenkou and Kevin P. Fiori
AIDS care, Vol.32(11), pp.1445-1450
11/01/2020
DOI: 10.1080/09540121.2020.1770672
PMCID: PMC7572731
PMID: 32460525
url
https://www.ncbi.nlm.nih.gov/pmc/articles/7572731View
Open Access

Abstract

The World Health Organization has prioritized integrating tuberculosis (TB) and human immunodeficiency virus (HIV) services. Diagnosis of HIV/TB coinfection in children remains a challenge worldwide for numerous reasons. The care delivery value chain (CDVC) is an effective tool that can be applied as a systemic framework for assessing health care delivery. Our objective was to apply the CDVC framework to improve pediatric HIV/TB care at an HIV center in northern Togo that serves over 130 children and 1000 adults living with HIV. Using the CDVC framework, gaps in HIV/TB care were identified, and services related to screening and diagnosis were prioritized to implement 3 distinct quality improvement cycles. Primary outcomes included percentage of children screened for TB by medical providers and percentage of diagnostic sample results received at the HIV clinic for children and adults. Improvements in the TB diagnostic process were observed, resulting in a change of sputum sample results received for both children and adults from 25% at baseline to >88% at 3 months. Given the relative low associated costs, this QI approach may be applicable and feasible in other settings to target screening and diagnosis of TB for children living with HIV worldwide.
 care delivery value chain global health pediatric HIV Pediatric tuberculosis Togo West Africa

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