One-stop TB-HIV services evaluation in Rwanda: comparison of the 2001-2005 and 2006-2010 cohorts.

BACKGROUND

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection remains high in Rwanda. Since one-stop TB-HIV services were implemented to manage TB-HIV co-infection, their functioning and impact on TB treatment outcomes have not been assessed.

OBJECTIVE

To evaluate one-stop TB-HIV services in Rwanda by comparing the TB treatment outcomes before and after their implementation in Kicukiro and Rulindo districts.

METHODS

This descriptive retrospective study used a quantitative questionnaire to determine the functioning of Rwanda's one-stop TB-HIV services. In-depth interviews and focus group discussions with health care providers, heads of facilities and co-infected patients were held to seek their opinion about the functioning of the services.

RESULTS

The one-stop TB-HIV services at all 12 health facilities visited were functioning according to the approved criteria. However, TB treatment outcomes after the intervention were not statistically different from those before the intervention. Qualitative data showed a positive impact on the quality of service, particularly a reduction in waiting times and appointments that were better respected as a result of the efficient functioning of the services.

CONCLUSION

One-stop TB-HIV services have improved the quality of service in Kicukiro and Rulindo districts. However, the services need to be strengthened programmatically to improve TB treatment outcomes.