Nurse led, primary care based antiretroviral treatment versus hospital care: a controlled prospective study in Swaziland

摘要: Antiretroviral treatment services delivered in hospital settings Africa increasingly lack capacity to meet demand and are difficult access by patients. We evaluate the effectiveness of nurse led primary care based antiretroviral comparison with usual a typical rural sub Saharan African setting. undertook prospective, controlled evaluation planned service change Lubombo, Swaziland. Clinically stable adults CD4 count > 100 on for at least four weeks district were assigned either or care. Assignment depended location nearest clinic. The main outcome measures clinic attendance patient experience. Those receiving less likely miss an appointment compared those continuing receive (RR 0·37, p < 0·0001). Average travel cost was half that (p = 0·001). based, more be satisfied ability staff manage their condition 1·23, 0·003). There no significant difference loss follow-up other health related outcomes modified intention treat analysis. Multilevel, multivariable regression identified little inter-cluster variation. Clinic experience better than care; appear equally good. This evidence supports efforts WHO scale-up universal Africa.