Voices from the Patients: A Qualitative Study of the Integration of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in O.R. Tambo District, Eastern Cape, South Africa

Round 1

Reviewer 1 Report

This study is an important and necessary. The authors have done a great job in performing this study and presenting it in a comprehensible manner. This provides an evidence-based need gap assessment of health care facilities in developing nations. We need more of such studies to provide the evidence to improve the healthcare system.

 

The paper is well written, but some improvements are needed.

 

I would recommend the authors to pay attention to minor spellings, sentence structures. Some of which I have indicated below. Similar errors are there throughout the paper. Please look into it and fix them.

 

1.     Line 115

 Spelling of “enrollment” and please rephrase the sentence.

 

“for enreolment into the study using the eligibility criteria earlier discused.”

 

2.     Line 125

FGD – please use the full form in this line, as it is the first time this acronym was used.

 

3.     While it is mentioned that patients were selected from registered patients at the clinic, there is no mention of whether written consent for this study was obtained for the FGD and the recording of the interviews?

 

4.     Line 225:

 Please correct errors:

 

5.     “The participants’ description indicated that there is an inadequate in understanding..”

 

6.     Line 228-229

 

“This description by participants has suggested that healthcare workers have to be consistently promote health education to..”

 

7.     Lines 239-246

The font size should be consistent. Italicized text is fine, but font size should be same. Please check throughout the paper.

 

Author Response

please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

This is an interesting paper which shows the TB, HIV or TB and HIV patients' views onTB-HIV intergration services in a municipality of South Africa. The paper could improve if the following comments are adressed:

Lines 101-103: The authors mention that “The five selected health facilities across OR Tambo district were purposively selected based on their burden of TB and or HIV. Although the five health posts were selected by simple randomization….” Please clarify how the 5 health facilities were selected

 

Lines 141-143: The authors describe the members of the groups as follows: There were five (5) face-to- face focus group discussions (FGDs) with each comprising of at least six participants; two (2) TB infected only females, two (2) HIV only males and two (2) coinfected males. Please explain group synthesis based on gender and disease- for example why weren’t any HIV only females included?

 

Table 1: Females accounted for 65% of participants-how is that possible when 4 out of 6 participants in each group were male?

 

Table 1: 55% of participants had a tertiary educational level. Is that representative of the community?

 

Were any differences on the perception of health services detected among TB, HIV and TB-HIV co0infected participants?

 

Discussion: The authors could comment on the impact of participants’ gender and especially education on the results of the study. It would be interesting to know how the results may differentiate if the participants education level was different.

 

Do the authors believe that their results are representative of South Africa (or ever the wider region) or just the O.R. Tambo municipality?

 

English language can be improved

 

Author Response

Please see the attachment.

Author Response File: Author Response.docx