Task shifting of antiretroviral treatment from doctors to primary-care nurses in South Africa (STRETCH): a pragmatic, parallel, cluster randomised trial
Open accessAbstract
Background Robust evidence of the effectiveness of task shifting of antiretroviral therapy (ART) from doctors to other health workers is scarce. We aimed to assess the effects on mortality, viral suppression, and other health outcomes and quality indicators of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) programme, which provides educational outreach training of nurses to initiate and represcribe ART, and to decentralise care.Methods We undertook a pragmatic, parallel, cluster-randomised trial in South Africa between Jan 28, 2008, and June 30, 2010. We randomly assigned 31 primary-care ART clinics to implement the STRETCH programme (intervention group) or to continue with standard care (control group). The ratio of randomisation depended on how many clinics were in each of nine strata. Two cohorts were enrolled: eligible patients in cohort 1 were adults (aged ≥16 years) with CD4 counts of 350 cells per μL or less who were not receiving ART; those in cohort 2 were adults who had already received ART for at least 6 months and were being treated at enrolment. The primary outcome in cohort 1 was time to death (superiority analysis). The primary outcome in cohort 2 was the proportion with undetectable viral loads (<400 copies per mL) 12 months after enrolment (equivalence analysis, prespecified difference <6%). Patients and clinicians could not be masked to group assignment. The interim analysis was blind, but data analysts were not masked after the database was locked for final analysis. Analyses were done by intention to treat. This trial is registered, number ISRCTN46836853.Findings 5390 patients in cohort 1 and 3029 in cohort 2 were in the intervention group, and 3862 in cohort 1 and 3202 in cohort 2 were in the control group. Median follow-up was 16·3 months (IQR 12·2-18·0) in cohort 1 and 18·0 months (18·0-18·0) in cohort 2. In cohort 1, 997 (20%) of 4943 patients analysed in the intervention group and 747 (19%) of 3862 in the control group with known vital status at the end of the trial had died. Time to death did not differ (hazard ratio [HR] 0·94, 95% CI 0·76-1·15). In a preplanned subgroup analysis of patients with baseline CD4 counts of 201-350 cells per μL, mortality was slightly lower in the intervention group than in the control group (0·73, 0·54-1.00; p=0·052), but it did not differ between groups in patients with baseline CD4 of 200 cells per μL or less (0·94, 0·76-1·15; p=0·577). In cohort 2, viral load suppression 12 months after enrolment was equivalent in intervention (2156 [71%] of 3029 patients) and control groups (2230 [70%] of 3202; risk difference 1·1%, 95% CI -2·4 to 4·6).Interpretation Expansion of primary-care nurses' roles to include ART initiation and represcription can be done safely, and improve health outcomes and quality of care, but might not reduce time to ART or mortality.Funding UK Medical Research Council, Development Cooperation Ireland, and Canadian International Development Agency.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The overall risk of bias for Fairall 2012 was low (3 criteria unclear risk).
“Risk of bias overall Low risk 3 criteria unclear risk”
From Tailored interventions to address determinants of practice (2015) · cites this paper as Fairall 2012
In dermatology, unlike in HIV or obstetrics, there are few examples of task shifting in resource-poor settings.
“In the field of dermatology, unlike in HIV or obstetrics (53–56), there are few examples of task shifting in resource-poor settings”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [54]
Clear positive impacts on health worker morale have been documented in parallel qualitative evaluations, with non-physician clinicians reporting empowerment and improved agency to manage patients.
“Clear positive impacts on health worker morale have been documented in parallel qualitative evaluations, with non-physician clinicians reporting a sense of empowerment and improved agency to manage patients 92,93 .”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [93]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Analysing controlled trials with baseline and follow up measurements
Vickers, A. J., & Altman, D. G. (2001) · BMJ · doi:10.1136/bmj.323.7321.1123 · Cited by 2,116 · see citing works
A systematic review of task- shifting for HIV treatment and care in Africa
Callaghan, M., Ford, N. P., & Schneider, H. M. (2010) · Human Resources for Health · doi:10.1186/1478-4491-8-8 · Cited by 637 · see citing works
Approaches to sample size estimation in the design of clinical trials—a review
DONNER, A. P. (1984) · Statistics in Medicine · doi:10.1002/sim.4780030302 · Cited by 250 · see citing works
Sanne, I., Orrell, C., Fox, M. P., Conradie, F., Ive, P., Zeinecker, J., Cornell, M., Heiberg, C., Ingram, C., Panchia, R., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60894-x · Cited by 248 · see citing works
Jaffar, S. S., Amuron, B., Foster, S. D., Birungi, J., Levin, J. B., Namara, G., Nabiryo, C., Ndembi, N., Kyomuhangi, R., Opio, A., et al. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61674-3 · Cited by 238 · see citing works
Cornell, M., Grimsrud, A., Fairall, L. R., Fox, M. P., Cutsem, G. V., Giddy, J., Wood, R., Prozesky, H. W., Mohapi, L., Graber, C., et al. (2010) · AIDS · doi:10.1097/qad.0b013e32833d45c5 · Cited by 224 · see citing works
Self-citationSelke, H. M., Kimaiyo, S. N., Sidle, J. E., Vedanthan, R., Tierney, W. M., Shen, C., Denski, C., Katschke, A. R., & Wools‐Kaloustian, K. (2010) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e3181eb5edb · Cited by 210 · see citing works
Effectiveness of antiretroviral treatment in a South African program: a cohort study.
Fairall, L., Bachmann, M., Louwagie, G., van Vuuren, C., Chikobvu, P., Steyn, D., Staniland, G. H., Timmerman, V., Msimanga, M., Seebregts, C., et al. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.10 · Cited by 207 · see citing works
Self-citationFairall, L. R., Zwarenstein, M., Bateman, E. D., Bachmann, M. O., Lombard, C. J., Majara, B. P., Joubert, G., English, R., Bheekie, A., van Rensburg, D. H., et al. (2005) · BMJ · doi:10.1136/bmj.331.7519.750 · Cited by 172 · see citing works
Self-citationEffect of Peer Health Workers on AIDS Care in Rakai, Uganda: A Cluster-Randomized Trial
Chang, L. W., Kagaayi, J., Nakigozi, G. F., Ssempijja, V., Packer, A. H., Serwadda, D., Quinn, T. C., Gray, R. H., Bollinger, R. C., & Reynolds, S. J. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010923 · Cited by 167 · see citing works
Ingle, S. M., May, M., Uebel, K., Timmerman, V., Kotzé, E., Bachmann, M. O., Sterne, J. A. C., Egger, M., & Fairall, L. R. (2010) · AIDS · doi:10.1097/qad.0b013e32833fb71f · Cited by 93 · see citing works
Self-citationPersonal information in medical research
Eckstein, S. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511550089.057 · Cited by 84 · see citing works
Zwarenstein, M., Fairall, L. R., Lombard, C., Mayers, P., Bheekie, A., English, R. G., Lewin, S., Bachmann, M. O., & Bateman, E. (2011) · BMJ · doi:10.1136/bmj.d2022 · Cited by 77 · see citing works
Self-citationExpanding access to ART in South Africa: The role of nurse-initiated treatment
Colvin, C. J., Fairall, L. R., Lewin, S. A., Georgeu-Pepper, D., Zwarenstein, M., Bachmann, M. O., Uebel, K., & Bateman, E. D. (2010) · South African Medical Journal · doi:10.7196/samj.4124 · Cited by 66 · see citing works
Self-citationApproaches to sample size estimation in the design of clinical trials—a review
Donner, B. A., & Makuch, R. (1985) · Statistics in Medicine · doi:10.1002/sim.4780040215 · Cited by 52 · see citing works
Uebel, K., Fairall, L. R., van Rensburg, D. H., Mollentze, W. F., Bachmann, M. O., Lewin, S. A., Zwarenstein, M., Colvin, C. J., Georgeu-Pepper, D., Mayers, P. M., et al. (2011) · Implementation Science · doi:10.1186/1748-5908-6-86 · Cited by 36 · see citing works
Self-citationMortality and causes of death in South Africa, 1997-2003: findings from death notifications
Dougan, S. (2005) · Weekly releases (1997–2007) · doi:10.2807/esw.10.13.02674-en · Cited by 27 · see citing works
Fairall, L. R., Bachmann, M. O., Zwarenstein, M., Lombard, C. J., Uebel, K., van Vuuren, C., Steyn, D., Boulle, A., & Bateman, E. D. (2008) · Trials · doi:10.1186/1745-6215-9-21 · Cited by 26 · see citing works
Self-citationSchull, M. J., Cornick, R., Thompson, S., Faris, G., Fairall, L., Burciul, B., Sodhi, S., Draper, B., Joshua, M., Mondiwa, M., et al. (2011) · Implementation Science · doi:10.1186/1748-5908-6-82 · Cited by 25 · see citing works
Self-citationBachmann, M. O., Fairall, L. R., Lombard, C. J., Timmerman, V., der Merwe, V., Bateman, E. D., & Zwarenstein, M. (2010) · PubMed · Cited by 22 · see citing works
Self-citationSchull, M. J., Banda, H., Kathyola, D., Fairall, L. R., Martiniuk, A. L. C., Burciul, B., Zwarenstein, M., Sodhi, S. K., Thompson, S., Joshua, M., et al. (2010) · Trials · doi:10.1186/1745-6215-11-118 · Cited by 18 · see citing works
Self-citationFree State ARV crisis--central government blamed.
Bateman, C. (2009) · PubMed · Cited by 2 · see citing works
Flagged first, then by citations
1 of the 23 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Evidence for Health Decision Making — Beyond Randomized, Controlled Trials
Frieden, T. R. (2017) · New England Journal of Medicine · doi:10.1056/nejmra1614394 · Cited by 770 · see citing works
Tailored interventions to address determinants of practice
Baker, R., Camosso-Stefinovic, J., Gillies, C., Shaw, E. J., Cheater, F., Flottorp, S., Robertson, N., Wensing, M., Fiander, M., Eccles, M. P., et al. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005470.pub3 · Cited by 711 · see citing works
Nurses as substitutes for doctors in primary care
Laurant, M., van der Biezen, M., Wijers, N., Watananirun, K., Kontopantelis, E., & van Vught, A. J. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001271.pub3 · Cited by 614 · see citing works
Joshi, R., Alim, M., Kengne, A. P., Jan, S., Maulik, P. K., Peiris, D., & Patel, A. A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0103754 · Cited by 589 · see citing works
Implementation Research in Health: A Practical Guide
Peters, D. H., Tran, N. T., & Adam, T. (2013) · Virtual Defense Library (Ministerio de Defensa) · Cited by 399 · see citing works
Global Burden of Skin Disease: Inequities and Innovations
Seth, D., Cheldize, K., Brown, D., & Freeman, E. E. (2017) · Current Dermatology Reports · doi:10.1007/s13671-017-0192-7 · Cited by 366 · see citing works
Substitution of physicians by nurses in primary care: a systematic review and meta-analysis
Martínez-González, N. A., Djalali, S., Tandjung, R., Huber-Geismann, F., Markun, S., Wensing, M., & Rosemann, T. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-214 · Cited by 310 · see citing works
Koenig, S. P., Dorvil, N., Dévieux, J. G., Hedt‐Gauthier, B., Riviere, C., Faustin, M., Lavoile, K., Perodin, C., Apollon, A., Duverger, L., et al. (2017) · PLoS Medicine · doi:10.1371/journal.pmed.1002357 · Cited by 282 · see citing works
Bollyky, T. J., Templin, T., Cohen, M., & Dieleman, J. L. (2017) · Health Affairs · doi:10.1377/hlthaff.2017.0708 · Cited by 282 · see citing works
Govindasamy, D., Meghji, J. Z., Negussie, E. K., Baggaley, R. C., Ford, N. P., & Kranzer, K. (2014) · Journal of the International AIDS Society · doi:10.7448/ias.17.1.19032 · Cited by 275 · see citing works
Weeks, G., George, J., MacLure, K., & Stewart, D. C. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011227.pub2 · Cited by 232 · see citing works
Task shifting in primary care to tackle healthcare worker shortages: An umbrella review
Leong, S. L., Teoh, S. L., Fun, W. H., & Lee, S. W. H. (2021) · European Journal of General Practice · doi:10.1080/13814788.2021.1954616 · Cited by 228 · see citing works
Research for Universal Health Coverage
Dye, C., Reeder, J. C., & Terry, R. F. (2013) · Science Translational Medicine · doi:10.1126/scitranslmed.3006971 · Cited by 228 · see citing works
Mendelson, M., Røttingen, J., Gopinathan, U., Hamer, D. H., Wertheim, H. F. L., Basnyat, B., Butler, C., Tomson, G. B., & Balasegaram, M. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00547-4 · Cited by 205 · see citing works
Oru, E., Trickey, A., Shirali, R., Kanters, S., & Easterbrook, P. (2021) · The Lancet Global Health · doi:10.1016/s2214-109x(20)30505-2 · Cited by 203 · see citing works
Redesigning Primary Care to Tackle the Global Epidemic of Noncommunicable Disease
Kruk, M. E., Nígenda, G., & Knaul, F. M. (2015) · American Journal of Public Health · doi:10.2105/ajph.2014.302392 · Cited by 189 · see citing works
Reframing HIV care: putting people at the centre of antiretroviral delivery
Duncombe, C. J., Rosenblum, S., Hellmann, N. S., Holmes, C. B., Wilkinson, L. S., Biot, M., Bygrave, H., Hoos, D., & Garnett, G. P. (2015) · Tropical Medicine & International Health · doi:10.1111/tmi.12460 · Cited by 187 · see citing works
Task shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy
Kredo, T., Adeniyi, F. B., Bateganya, M. H., & Pienaar, E. D. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007331.pub3 · Cited by 181 · see citing works
Implementation science in resource-poor countries and communities
Yapa, H. M., & Bärnighausen, T. (2018) · Implementation Science · doi:10.1186/s13012-018-0847-1 · Cited by 170 · see citing works
Ridgeway, K., Dulli, L., Murray, K., Silverstein, H. A., Santo, L. D., Olsen, P., Mora, D. D. D., & McCarraher, D. R. (2018) · PLoS ONE · doi:10.1371/journal.pone.0189770 · Cited by 165 · see citing works
Martínez-González, N. A., Tandjung, R., Djalali, S., & Rosemann, T. J. (2015) · Human Resources for Health · doi:10.1186/s12960-015-0049-8 · Cited by 164 · see citing works
Murray, K., Dulli, L., Ridgeway, K., Santo, L. D., Mora, D. D. D., Olsen, P., Silverstein, H. A., & McCarraher, D. R. (2017) · PLoS ONE · doi:10.1371/journal.pone.0184879 · Cited by 158 · see citing works
Chang, L. W., Serwadda, D., Quinn, T. C., Wawer, M. J., Gray, R. H., & Reynolds, S. J. (2012) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70273-6 · Cited by 153 · see citing works
Barnabas, R. V., Szpiro, A. A., van Rooyen, H., Asiimwe, S. B., Pillay, D., Ware, N. C., Schaafsma, T. T., Krows, M. L., van Heerden, A. C., Joseph, P., et al. (2020) · The Lancet Global Health · doi:10.1016/s2214-109x(20)30313-2 · Cited by 143 · see citing works
Thornicroft, G., Ahuja, S., Barber, S., Chisholm, D., Collins, P. Y., Docrat, S., Fairall, L., Lempp, H., Niaz, U., Ngo, V., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30298-0 · Cited by 138 · see citing works
Self-citationAssisted partner services for HIV in Kenya: a cluster randomised controlled trial
Cherutich, P., Golden, M. R., Wamuti, B., Richardson, B. A., Ásbjörnsdóttir, K., Otieno, F. A., Ng’ang’a, A., Mutiti, P. M., Macharia, P. M., Sambai, B., et al. (2016) · The Lancet HIV · doi:10.1016/s2352-3018(16)30214-4 · Cited by 130 · see citing works
Georgeu, D., Colvin, C. J., Lewin, S., Fairall, L., Bachmann, M. O., Uebel, K., Zwarenstein, M., Draper, B., & Bateman, E. D. (2012) · Implementation Science · doi:10.1186/1748-5908-7-66 · Cited by 115 · see citing works
Self-citationNachega, J. B., Uthman, O. A., del Rı́o, C., Mugavero, M. J., Rees, H., & Mills, E. J. (2014) · Clinical Infectious Diseases · doi:10.1093/cid/ciu299 · Cited by 104 · see citing works
Rethinking assumptions about delivery of healthcare: implications for universal health coverage
Das, J., Woskie, L., Rajbhandari, R., Abbasi, K. A., & Jha, A. K. (2018) · BMJ · doi:10.1136/bmj.k1716 · Cited by 104 · see citing works
Potthoff, S., Finch, T. L., Bührmann, L., Etzelmüller, A., van Genugten, C., Girling, M., May, C. R., Perkins, N., Vis, C., & Rapley, T. (2023) · Health Expectations · doi:10.1111/hex.13808 · Cited by 104 · see citing works
Fairall, L. R., Folb, N., Timmerman, V., Lombard, C., Steyn, K., Bachmann, M. O., Bateman, E. D., Lund, C., Cornick, R., Faris, G., et al. (2016) · PLoS Medicine · doi:10.1371/journal.pmed.1002178 · Cited by 99 · see citing works
Self-citationMan, J. D., Mayega, R. W., Sarkar, N. D. P., Waweru, E., Leys, M., van Olmen, J., & Criel, B. (2016) · The International Journal of Person Centered Medicine · doi:10.5750/ijpcm.v6i3.591 · Cited by 99 · see citing works
Differentiated service delivery
Ehrenkranz, P. D., Grimsrud, A., & Rabkin, M. (2018) · Current Opinion in HIV and AIDS · doi:10.1097/coh.0000000000000509 · Cited by 98 · see citing works
Leveraging nurse practitioner capacities to achieve global health for all: COVID‐19 and beyond
Rosa, W. E., Fitzgerald, M. G., Davis, S., Farley, J. E., Khanyola, J., Kwong, J. J., Moreland, P., Rogers, M., Sibanda, B., & Turale, S. (2020) · International Nursing Review · doi:10.1111/inr.12632 · Cited by 82 · see citing works
Cornick, R., Picken, S., Wattrus, C., Awotiwon, A., Carkeek, E., Hannington, J., Spiller, P., Bateman, E., Doherty, T., Zwarenstein, M., et al. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2018-000962 · Cited by 84 · see citing works
Self-citationCrowley, T., & Mayers, P. (2015) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v7i1.807 · Cited by 78 · see citing works
Fatti, G., Ngorima‐Mabhena, N., Mothibi, E., Muzenda, T., Choto, R. C., Kasu, T., Tafuma, T. A., Mahachi, N., Takarinda, K. C., Apollo, T., et al. (2020) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002333 · Cited by 78 · see citing works
Martínez-González, N. A., Tandjung, R., Djalali, S., Huber-Geismann, F., Markun, S., & Rosemann, T. J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089181 · Cited by 76 · see citing works
Gaziano, T. A., Bertram, M., Tollman, S. M., & Hofman, K. J. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-240 · Cited by 74 · see citing works
Prevention of mother-to-child transmission in South Africa: an ever-changing landscape
Burton, R., Giddy, J., & Stinson, K. (2015) · Obstetric Medicine · doi:10.1177/1753495x15570994 · Cited by 73 · see citing works
Innovating to improve primary care in less developed countries: towards a global model
Fairall, L. R., Bateman, E. D., Cornick, R. V., Faris, G. M., Timmerman, V., Folb, N., Bachmann, M. O., Zwarenstein, M., & Smith, R. W. (2015) · BMJ Innovations · doi:10.1136/bmjinnov-2015-000045 · Cited by 73 · see citing works
Self-citationSuthar, A. B., Rutherford, G. W., Horváth, H., Doherty, M. C., & Negussie, E. K. (2014) · AIDS · doi:10.1097/qad.0000000000000259 · Cited by 71 · see citing works
Fox, M. P., Rosen, S. B., Geldsetzer, P., Bärnighausen, T., Negussie, E. K., & Beanland, R. L. (2016) · Journal of the International AIDS Society · doi:10.7448/ias.19.1.20888 · Cited by 68 · see citing works
Iwu, E., & Holzemer, W. L. (2013) · AIDS Care · doi:10.1080/09540121.2013.793278 · Cited by 68 · see citing works
Genberg, B. L., Yebei, V. N., Wachira, J., Hogan, J. W., Sang, E., Nyambura, M., Odawa, M., Duefield, C., Ndege, S., & Braitstein, P. K. A. (2014) · The Lancet HIV · doi:10.1016/s2352-3018(14)00034-4 · Cited by 65 · see citing works
The 2013 WHO guidelines for antiretroviral therapy
Doherty, M. C., Ford, N. P., Vitória, M., Weiler, G., & Hirnschall, G. O. (2013) · Current Opinion in HIV and AIDS · doi:10.1097/coh.0000000000000008 · Cited by 64 · see citing works
Guilamo‐Ramos, V., Thimm-Kaiser, M., Benzekri, A., Hidalgo, A., Lanier, Y., Tlou, S. D., López, M. D. L. R., Soletti, A. B., & Hagan, H. (2021) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(20)30983-x · Cited by 64 · see citing works
Uebel, K., Guise, A., Georgeu-Pepper, D., Colvin, C. J., & Lewin, S. A. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-171 · Cited by 63 · see citing works
Self-citationBoyles, T. H., Naicker, V., Rawoot, N., Raubenheimer, P. J., Eick, B., & Mendelson, M. (2017) · South African Medical Journal · doi:10.7196/samj.2017.v107i2.12067 · Cited by 63 · see citing works
Mahajan, S., Mukhiya, G. K., Singh, R., Tiwari, S. C., Kalra, V., Bhowmik, D. M., Gupta, S. K., Agarwal, S. K., & Dash, S. C. (2005) · Journal of Nephrology · doi:10.1093/joneph/18.3.257 · Cited by 61 · see citing works
Hagey, J. M., Li, X., Barr‐Walker, J., Penner, J. A., Kadima, J., Oyaro, P., & Cohen, C. R. (2018) · AIDS Care · doi:10.1080/09540121.2018.1500995 · Cited by 59 · see citing works
Assefa, Y. A., Alebachew, A., Lera, M., Lynen, L., Wouters, E., & Damme, W. V. (2014) · Globalization and Health · doi:10.1186/1744-8603-10-43 · Cited by 58 · see citing works
Sodhi, S. K., Banda, H., Kathyola, D., Joshua, M., Richardson, F., Mah, E., MacGregor, H., Kanike, E., Thompson, S., Fairall, L. R., et al. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-s1-s8 · Cited by 56 · see citing works
Self-citationTukei, B. B., Fatti, G., Tiam, A., Ngorima‐Mabhena, N., Tukei, V. J., Tshabalala, I., Sejana, M. V., Muzenda, T., Mokoroane, L. M., Sehlabo, L., et al. (2020) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002439 · Cited by 55 · see citing works
the CobALT research team, Fairall, L., Petersen, I., Zani, B., Folb, N., Georgeu-Pepper, D., Selohilwe, O., Petrus, R., Mntambo, N., Bhana, A., et al. (2018) · Trials · doi:10.1186/s13063-018-2517-7 · Cited by 53 · see citing works
Self-citationEmdin, C. A., Chong, N. J., & Millson, P. E. (2013) · Journal of the International AIDS Society · doi:10.7448/ias.16.1.18445 · Cited by 53 · see citing works
The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review
Martínez-González, N. A., Rosemann, T. J., Tandjung, R., & Djalali, S. (2015) · Swiss Medical Weekly · doi:10.4414/smw.2015.14031 · Cited by 52 · see citing works
Kiweewa, F. M., Wabwire, D., Nakibuuka, J., Mubiru, M., Bagenda, D. S., Musoke, P., Fowler, M. G., & Antelman, G. (2013) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e3182987ce6 · Cited by 51 · see citing works
Cailhol, J., Craveiro, I. M. R., Madede, T., Makoa, E., Mathole, T., Parsons, A., Leemput, L. V., Biesma, R. G., Brugha, R., Chilundo, B., et al. (2013) · Globalization and Health · doi:10.1186/1744-8603-9-52 · Cited by 50 · see citing works
Pham, M. D., Romero, L., Parnell, B., Anderson, D. A., Crowe, S. M., & Luchters, S. M. F. (2017) · AIDS Research and Therapy · doi:10.1186/s12981-017-0131-5 · Cited by 50 · see citing works
Barrera-Cancedda, A. E., Connell, K. A., Shinnick, J. E., & Buttenheim, A. M. (2019) · Implementation Science · doi:10.1186/s13012-019-0958-3 · Cited by 48 · see citing works
Mutabazi, J. C., Gray, C., Muhwava, L. S., Trottier, H., Ware, L. J., Norris, S. A., Murphy, K., Levitt, N. S., & Zarowsky, C. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05381-5 · Cited by 48 · see citing works
Antimicrobial stewardship in South Africa: a scoping review of the published literature
Chetty, S., Reddy, M., Ramsamy, Y., Naidoo, A., & Essack, S. Y. (2019) · JAC-Antimicrobial Resistance · doi:10.1093/jacamr/dlz060 · Cited by 45 · see citing works
Christmals, C. D., & Armstrong, S. J. (2019) · Heliyon · doi:10.1016/j.heliyon.2019.e02531 · Cited by 44 · see citing works
Rabkin, M., de Pinho, H., Michaels-Strasser, S., Naitore, D., Rawat, A., & Topp, S. M. (2018) · AIDS · doi:10.1097/qad.0000000000001895 · Cited by 43 · see citing works
Task Shifting for the Delivery of Pediatric Antiretroviral Treatment
Penazzato, M., Davies, M., Apollo, T., Negussie, E. K., & Ford, N. P. (2013) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000000024 · Cited by 42 · see citing works
Feyissa, Y. M., Hanlon, C., Ferede, S. E., Cornick, R. V., Fairall, L. R., Gebremichael, D., Teka, T., Shiferaw, S., Dagnaw, W. W., Mamo, Y., et al. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2018-001108 · Cited by 41 · see citing works
Self-citationGreen, A. F., Azevedo, V. D., Patten, G., Davies, M., Ibeto, M., & Cox, V. (2014) · PLoS ONE · doi:10.1371/journal.pone.0098389 · Cited by 40 · see citing works
Implementation and Operational Research
Herlihy, J. M., Hamomba, L., Bonawitz, R. E., Goggin, C. E., Sambambi, K., Mwale, J., Musonda, V., Musokatwane, K., Hopkins, K. L., Semrau, K. E. A., et al. (2015) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000000760 · Cited by 40 · see citing works
Castro‐Sánchez, E., Gilchrist, M. J., Ahmad, R., Courtenay, M., Bosanquet, J., & Holmes, A. H. (2019) · Antimicrobial Resistance and Infection Control · doi:10.1186/s13756-019-0621-4 · Cited by 40 · see citing works
Simelane, M. L., Georgeu-Pepper, D., Ras, C., Anderson, L. R., Pascoe, M., Faris, G. M., Fairall, L. R., & Cornick, R. V. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2018-001124 · Cited by 40 · see citing works
Self-citationHickey, M. D., Odeny, T., Petersen, M. L., Neilands, T. B., PADIAN, N. S., Ford, N. P., Matthay, Z. A., Hoos, D., Doherty, M. C., Beryer, C., et al. (2017) · Implementation Science · doi:10.1186/s13012-017-0630-8 · Cited by 39 · see citing works
Faturiyele, I., Appolinare, T., Ngorima‐Mabhena, N., Fatti, G., Tshabalala, I., Tukei, V. J., & Pisa, P. T. (2018) · BMC Public Health · doi:10.1186/s12889-018-5961-0 · Cited by 39 · see citing works
Chang, L. W., Nakigozi, G. F., Billioux, V. G., Gray, R. H., Serwadda, D., Quinn, T. C., Wawer, M. J., Bollinger, R. C., & Reynolds, S. J. (2015) · AIDS and Behavior · doi:10.1007/s10461-015-1159-y · Cited by 38 · see citing works
Gupta, N., & Bukhman, G. (2015) · Healthcare · doi:10.1016/j.hjdsi.2015.09.006 · Cited by 37 · see citing works
Kredo, T., Cooper, S., Abrams, A. L., Müller, J. G., Volmink, J. A., & Atkins, S. A. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3778-2 · Cited by 38 · see citing works
Ford, N. P., Swan, T., Beyer, P., Hirnschall, G. O., Easterbrook, P., & Wiktor, S. Z. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.09.019 · Cited by 36 · see citing works
Evaluating strategies to improve HIV care outcomes in Kenya: a modelling study
Olney, J., Braitstein, P. K. A., Eaton, J. W., Sang, E., Nyambura, M., Kimaiyo, S. N., McRobie, E., Hogan, J. W., & Hallett, T. B. (2016) · The Lancet HIV · doi:10.1016/s2352-3018(16)30120-5 · Cited by 35 · see citing works
Lazarus, J. V., Safreed‐Harmon, K., Nicholson, J., & Jaffar, S. S. (2014) · Tropical Medicine & International Health · doi:10.1111/tmi.12366 · Cited by 34 · see citing works
Gopinathan, U., Lewin, S. A., & Glenton, C. (2014) · Tropical Medicine & International Health · doi:10.1111/tmi.12381 · Cited by 34 · see citing works
Self-citationPadigos, J., Reid, S. A., Kirby, E. R., & Broom, J. K. (2020) · Journal of Hospital Infection · doi:10.1016/j.jhin.2020.12.003 · Cited by 33 · see citing works
Jain, V., Byonanebye, D. M., Amanyire, G., Kwarisiima, D., Black, D., Kabami, J., Chamie, G., Clark, T. D., Rooney, J. F., Charlebois, E. D., et al. (2014) · AIDS · doi:10.1097/qad.0000000000000401 · Cited by 32 · see citing works
Hopwood, H., Sevalie, S., Herman, M. O., Harris, D., Collet, K., Bah, A. J., & Beynon, F. (2021) · International Journal of Mental Health Systems · doi:10.1186/s13033-021-00455-1 · Cited by 31 · see citing works
Weaver, M. R., Burnett, S., Crozier, I., Kinoti, S. N., Kirunda, I., Mbonye, M. K., Naikoba, S., Ronald, A., Rubashembusya, T., Zawedde‐Muyanja, S., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0103017 · Cited by 31 · see citing works
Ford, N. P., Wiktor, S. Z., Kaplan, K., Andrieux‐Meyer, I., Hill, A. M., Radhakrishnan, P., Londeix, P., Forette, C., Momenghalibaf, A., Verster, A. D., et al. (2015) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2015.05.004 · Cited by 31 · see citing works
Wollum, A., Gabert, R., McNellan, C. R., Daly, J., Reddy, P. S., Bhatt, P., Bryant, M., Colombara, D. V., Naidoo, P., Ngongo, B., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0192603 · Cited by 31 · see citing works
Smith, J. R., Odera, D., Chege, D., Muigai, E., Patnaik, P., Michaels-Strasser, S., Howard, A. A., Yu-Shears, J., & Dohrn, J. (2016) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/j.jana.2016.01.005 · Cited by 30 · see citing works
Nurse Prescribing From the Global Vantage Point: The Intersection Between Role and Policy
Ladd, E., & Schober, M. M. (2018) · Policy Politics & Nursing Practice · doi:10.1177/1527154418797726 · Cited by 30 · see citing works
Effects of task-shifting from primary care physicians to nurses: an overview of systematic reviews
Paier-Abuzahra, M., Posch, N., Jeitler, K., Semlitsch, T., Radl-Karimi, C., Spary-Kainz, U., Horvath, K., & Siebenhofer, A. (2024) · Human Resources for Health · doi:10.1186/s12960-024-00956-3 · Cited by 29 · see citing works
Barton, G., Fairall, L. R., Bachmann, M. O., Uebel, K., Timmerman, V., Lombard, C. J., & Zwarenstein, M. (2013) · Tropical Medicine & International Health · doi:10.1111/tmi.12093 · Cited by 29 · see citing works
Self-citationMarotta, C., Giaquinto, C., Gennaro, F. D., Chhaganlal, K. D., Saracino, A., Moiane, J., Maringhini, G., Pizzol, D., Putoto, G., Monno, L., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5646-8 · Cited by 29 · see citing works
Tucker, J. D., Wei, C., Pendse, R., & Lo, Y.-R. J. (2015) · Journal of Virus Eradication · doi:10.1016/s2055-6640(20)31145-6 · Cited by 29 · see citing works
Gerritsen, A., de Rooij, T., Dijkgraaf, M. G. W., Busch, O. R., Bergman, J. J. G. H. M., Ubbink, D. T., van Duijvendijk, P., Erkelens, W. G., Klos, M., Kruyt, P. M., et al. (2016) · The American Journal of Gastroenterology · doi:10.1038/ajg.2016.224 · Cited by 28 · see citing works
Machingaidze, S., Zani, B., Abrams, A. L., Durão, S., Louw, Q. A., Kredo, T., Grimmer, K. A., & Young, T. (2016) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2016.09.015 · Cited by 28 · see citing works
McHugh, G., Simms, V. M., Dauya, E., Bandason, T., Chonzi, P., Metaxa, D., Munyati, S. S., Nathoo, K., Mujuru, H. A., Kranzer, K., et al. (2017) · Journal of the International AIDS Society · doi:10.7448/ias.20.1.21843 · Cited by 28 · see citing works
A Global Antimicrobial Conservation Fund for Low- and Middle-Income Countries
Mendelson, M., Dar, O. A., Hoffman, S. J., Laxminarayan, R., Mpundu, M. M., & Røttingen, J. (2016) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2016.09.016 · Cited by 28 · see citing works
Passing the baton to pharmacists and nurses: New models of antibiotic stewardship for South Africa?
Brink, A. J., van den Bergh, D., Mendelson, M., & Richards, G. (2016) · South African Medical Journal · doi:10.7196/samj.2016.v106i10.11448 · Cited by 28 · see citing works
Cornick, R. V., Wattrus, C., Eastman, T., Ras, C., Awotiwon, A., Anderson, L. R., Bateman, E. D., Zepeda, J., Zwarenstein, M., Doherty, T., et al. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2018-001088 · Cited by 28 · see citing works
Self-citationO’Malley, G., Asrat, L., Sharma, A., Hamunime, N., Stephanus, Y., Brandt, L., Ali, D., Kaindjee-Tjituka, F., Natanael, S., Gweshe, J., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0092014 · Cited by 27 · see citing works
Bärnighausen, T., Bloom, D. E., & Humair, S. (2016) · PLoS ONE · doi:10.1371/journal.pone.0163960 · Cited by 27 · see citing works
- Authors
- Fairall, L., Bachmann, M. O., Lombard, C., Timmerman, V., Uebel, K., Zwarenstein, M., Boulle, A., Georgeu, D., Colvin, C. J., Lewin, S., Faris, G., Cornick, R., Draper, B., Tshabalala, M., Kotze, E., van Vuuren, C., Steyn, D., Chapman, R., & Bateman, E.
- Affiliations
- University of Cape Town (ZA)
- University of East Anglia (GB)
- South African Medical Research Council (ZA)
- Western University (CA)
- University of the Free State (ZA)
- Medical Research Council (GB)
- Corresponding author
- Bachmann, Max O
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 380
- Issue
- 9845
- Pages
- 889-898
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC3442223
- OpenAlex
- W2128478603
- Cited by
- 302
- References
- 23
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 26 · 2023: 8 · 2022: 7 · 2021: 12 · 2020: 26 · 2019: 16 · 2018: 34 · 2017: 26 · 2016: 27 · 2015: 34 · 2014: 38 · 2013: 27 · 2012: 6
- FWCI
- 23.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- National Health Laboratory Service
- Medical Research Council
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Keywords
- task shifting, antiretroviral therapy, primary care nurses, HIV, decentralization of care, viral suppression, mortality, CD4 count, healthcare workers, South Africa, quality indicators
- MeSH terms
- Adult, Delivery of Health Care, Female, Humans, Male, Middle Aged, Drug Prescriptions, Primary Health Care, South Africa, HIV Infections, Treatment Outcome, CD4 Lymphocyte Count, Anti-HIV Agents, Viral Load, Primary Care Nursing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
