One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda

Abstract The study aim was to determine the association of a one United States dollar (USD) dollar incentive and tuberculosis (TB) treatment outcomes among people with TB receiving treatment at a rural hospital in Uganda under programmatic settings. We conducted a quasi-experiment in which people wi...

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Autores principales:	Joseph Baruch Baluku, Bridget Nakazibwe, Bright Twinomugisha, Rebecca Najjuuko, Nyirazihawe Isabella, Sylvia Nassozi, Sharon Namiiro, Winceslaus Katagira, Dathan Mirembe Byonanebye, Christine Sekaggya-Wiltshire, Joseph Muchiri, Elizabeth Ndungu, Godwin Anguzu, Harriet Mayanja-Kizza, Irene Andia-Biraro
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1f92a0956ac848e58063d3766bc5562e
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spelling	oai:doaj.org-article:1f92a0956ac848e58063d3766bc5562e2021-12-02T17:37:29ZOne dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda10.1038/s41598-021-98770-72045-2322https://doaj.org/article/1f92a0956ac848e58063d3766bc5562e2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98770-7https://doaj.org/toc/2045-2322Abstract The study aim was to determine the association of a one United States dollar (USD) dollar incentive and tuberculosis (TB) treatment outcomes among people with TB receiving treatment at a rural hospital in Uganda under programmatic settings. We conducted a quasi-experiment in which people with TB were randomised (1:1 ratio) to receive either a one USD incentive at months 0, 2, 5 and 6 (Dollar arm) or routine care (Routine arm). A second control group (Retrospective controls) consisted of participants who had a treatment outcome in the preceding 6 months. Treatment outcomes were compared between the intervention and control groups using Pearson’s chi-square and Fisher’s exact tests. The association between the incentive and treatment outcomes was determined using Poisson regression analysis with robust variances. Between November 2018 and October 2019, we enrolled 180 participants (60 in the Dollar arm and 120 in the Control group). TB cure (33.3% vs. 20.8%, p = 0.068) and treatment success (70.0% vs. 59.2% p = 0.156) were higher in the Dollar arm than the Control group, while loss-to-follow-up was lower in the Dollar arm (10.0% vs. 20.8% p = 0.070). Participants in the Dollar arm were more likely to be cured (adjusted incidence rate ratio (aIRR): 1.59, 95% CI 1.04–2.44, p = 0.032) and less likely to be lost to follow-up (aIRR: 0.44, 95% CI 0.20–0.96, p = 0.040). A one-dollar incentive was associated with higher TB cure and lower loss-to-follow-up among people with TB in rural Uganda.Joseph Baruch BalukuBridget NakazibweBright TwinomugishaRebecca NajjuukoNyirazihawe IsabellaSylvia NassoziSharon NamiiroWinceslaus KatagiraDathan Mirembe ByonanebyeChristine Sekaggya-WiltshireJoseph MuchiriElizabeth NdunguGodwin AnguzuHarriet Mayanja-KizzaIrene Andia-BiraroNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joseph Baruch Baluku Bridget Nakazibwe Bright Twinomugisha Rebecca Najjuuko Nyirazihawe Isabella Sylvia Nassozi Sharon Namiiro Winceslaus Katagira Dathan Mirembe Byonanebye Christine Sekaggya-Wiltshire Joseph Muchiri Elizabeth Ndungu Godwin Anguzu Harriet Mayanja-Kizza Irene Andia-Biraro One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda
description	Abstract The study aim was to determine the association of a one United States dollar (USD) dollar incentive and tuberculosis (TB) treatment outcomes among people with TB receiving treatment at a rural hospital in Uganda under programmatic settings. We conducted a quasi-experiment in which people with TB were randomised (1:1 ratio) to receive either a one USD incentive at months 0, 2, 5 and 6 (Dollar arm) or routine care (Routine arm). A second control group (Retrospective controls) consisted of participants who had a treatment outcome in the preceding 6 months. Treatment outcomes were compared between the intervention and control groups using Pearson’s chi-square and Fisher’s exact tests. The association between the incentive and treatment outcomes was determined using Poisson regression analysis with robust variances. Between November 2018 and October 2019, we enrolled 180 participants (60 in the Dollar arm and 120 in the Control group). TB cure (33.3% vs. 20.8%, p = 0.068) and treatment success (70.0% vs. 59.2% p = 0.156) were higher in the Dollar arm than the Control group, while loss-to-follow-up was lower in the Dollar arm (10.0% vs. 20.8% p = 0.070). Participants in the Dollar arm were more likely to be cured (adjusted incidence rate ratio (aIRR): 1.59, 95% CI 1.04–2.44, p = 0.032) and less likely to be lost to follow-up (aIRR: 0.44, 95% CI 0.20–0.96, p = 0.040). A one-dollar incentive was associated with higher TB cure and lower loss-to-follow-up among people with TB in rural Uganda.
format	article
author	Joseph Baruch Baluku Bridget Nakazibwe Bright Twinomugisha Rebecca Najjuuko Nyirazihawe Isabella Sylvia Nassozi Sharon Namiiro Winceslaus Katagira Dathan Mirembe Byonanebye Christine Sekaggya-Wiltshire Joseph Muchiri Elizabeth Ndungu Godwin Anguzu Harriet Mayanja-Kizza Irene Andia-Biraro
author_facet	Joseph Baruch Baluku Bridget Nakazibwe Bright Twinomugisha Rebecca Najjuuko Nyirazihawe Isabella Sylvia Nassozi Sharon Namiiro Winceslaus Katagira Dathan Mirembe Byonanebye Christine Sekaggya-Wiltshire Joseph Muchiri Elizabeth Ndungu Godwin Anguzu Harriet Mayanja-Kizza Irene Andia-Biraro
author_sort	Joseph Baruch Baluku
title	One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda
title_short	One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda
title_full	One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda
title_fullStr	One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda
title_full_unstemmed	One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda
title_sort	one dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural uganda
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1f92a0956ac848e58063d3766bc5562e
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One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda

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