Effects of financial incentives for treatment supporters on tuberculosis treatment outcomes in Swaziland: a pragmatic interventional study.

Merav Kliner, Mamvura Canaan, Sifiso Zwide Ndwandwe, Fred Busulwa, William Welfare, Marty Richardson, John Walley, John Wright

    Research output: Contribution to journalArticlepeer-review

    Abstract

    BACKGROUND: Swaziland has the highest national incidence of tuberculosis (TB) in the world, with treatment success rates well below the 85 % international target. Treatment support as part of comprehensive TB services is a core component of the Stop TB Strategy. This study investigated the effects of financial incentives for treatment supporters on TB treatment outcomes in Swaziland. METHODS: This was a controlled study that compared treatment outcomes for patients with a treatment supporter who received or did not receive a financial incentive. RESULTS: The intervention group had a higher chance of treatment success as compared with the control group: 73 % (95 % confidence intervals [CIs] 66-80 %) versus 60 % (95 % CIs 57-64 %), respectively, p = 0.003. This improvement remained significant when treatment success rates were adjusted for differences in baseline characteristics, with the effect of incentivised treatment supporters on treatment outcomes having an odds ratio (OR) of 1.8. There was also a significant improvement in the death rate in the intervention group, as compared with the control group (10.6 versus 23.5 %, p = 
    Original languageEnglish
    JournalInfectious diseases of poverty
    Volume4
    DOIs
    Publication statusPublished - 2015

    Keywords

    • Africa
    • Swaziland
    • Treatment success
    • Tuberculosis

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