All physicians participating in this project were requested to use sputum microscopy for all TB suspects, and were advised to send patients to NTP laboratories. Physicians were asked to perform disease classification and treatment following NTP guidelines; alternatively, patients could be sent to the NTP for treatment. The project also initiated the use of a treatment card for all patients, and pharmacies were requested to advise customers with a cough of more than 3 weeks to go to the NTP for sputum examination.
All PPs were asked to accept quarterly NTP supervisory visits. No drugs were to be distributed by the NTP; patients treated by PPs were expected to buy drugs (as is routine in the private sector) either directly from the physician or from a private pharmacy through a prescription. PPs were instructed to inform patients about the option of free treatment in the NTP.
PPs received a financial incentive of US$0.80 for each sputum smear-positive case detected, US$10 for each case treated (cured, completed or failure cases) and US$5 per case transferred to the NTP.
Results: A total of 1549 TB suspects were referred, of whom 1090 (70%) actually went to the NTP for sputum examination. A total of 569 cases were detected through referrals or notification, of whom 45% were new sputum smear-positive cases. The case detection of new sputum smear-positive cases in PPM districts increased by 18% (21/100 000, 95%CI 0–42) compared to the previous year, while a slight decrease occurred in control districts. In HCMC as a whole, case detection increased by 7% (7/100 000, 95%CI 2–11/100000).
Information verified by CHMI-Vietnam