{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:30:41Z","timestamp":1792006241195,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,12,10]],"date-time":"2012-12-10T00:00:00Z","timestamp":1355097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Given the imperative to scale up integrated tuberculosis (<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> services in settings where both are of major public health importance, we aimed to synthesise knowledge concerning implementation of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> service integration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Systematic review of studies describing a strategy to facilitate <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> service integration, searching 15 bibliographic databases including <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edline, <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>mbase and the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ochrane library; and relevant conference abstracts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010three of 1936 peer\u2010reviewed articles and 70 of 170 abstracts met our inclusion criteria. We identified five models: entry via <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> service, with referral for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing and care; entry via <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> service, on\u2010site <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing, and referral for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> care; entry via <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> service with referral for <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> screening and treatment; entry via <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> service, on\u2010site <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> screening, and referral for <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> diagnosis and treatment; and <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> services provided at a single facility. Referral\u2010based models are most easily implemented, but referral failure is a key risk. Closer integration requires more staff training and additional infrastructure (e.g. private space for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> counselling; integrated records). Infection control is a major concern. More integrated models hold potential efficiencies from both provider and user perspective. Most papers report \u2018outcomes\u2019 (e.g. proportion of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patients tested for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>); few report downstream \u2018impacts\u2019 such as outcomes of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> treatment or antiretroviral therapy. Very few studies address the perspectives of service users or staff, or costs or cost\u2010effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While scaling up integrated services, robust comparisons of the impacts of different models are needed using standardised outcome measures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12029","type":"journal-article","created":{"date-parts":[[2012,12,10]],"date-time":"2012-12-10T10:29:38Z","timestamp":1355135378000},"page":"199-211","source":"Crossref","is-referenced-by-count":105,"title":["Integrating tuberculosis and <scp>HIV<\/scp> services in low\u2010 and middle\u2010income countries: a systematic review"],"prefix":"10.1111","volume":"18","author":[{"given":"Helena","family":"Legido\u2010Quigley","sequence":"first","affiliation":[{"name":"Department of Clinical Research London School of Hygiene and Tropical Medicine and Evidence for Action Consortium London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene and Tropical Medicine and Evidence for Action Consortium London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palwasha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene and Tropical Medicine and Evidence for Action Consortium London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rifat","family":"Atun","sequence":"additional","affiliation":[{"name":"Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ade","family":"Fakoya","sequence":"additional","affiliation":[{"name":"The International HIV\/AIDS Alliance and Evidence for Action Consortium, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haileyesus","family":"Getahun","sequence":"additional","affiliation":[{"name":"Stop TB Department World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison D.","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Clinical Research London School of Hygiene and Tropical Medicine and Evidence for Action Consortium London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,12,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czp053"},{"key":"e_1_2_8_3_1","first-page":"CD003318","article-title":"Strategies for integrating primary health services in middle\u2010 and low\u2010income countries at the point of delivery","volume":"2","author":"Briggs C","year":"2006","journal-title":"The Cochrane Database of Systematic Reviews"},{"key":"e_1_2_8_4_1","unstructured":"BuruaA MusisiA TumwesigyeBet\u00a0al. 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