Facilitators and barriers to TB care during the COVID-19 pandemic.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2022-12-21 DOI:10.5588/pha.22.0039

M A Franke, L M Truß, H Wierenga, K Nordmann, A Frühauf, R Ranaivoson, Z Rampanjato, F Ranjaharinony, S Knauss, N Muller, J V Emmrich

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引用次数: 1

Abstract

Background: Knowledge about factors influencing access and adherence to TB care, and on the impact of the COVID-19 pandemic on TB care in resource-restricted settings is scarce. We conducted this study in Atsimo-Andrefana, a rural region in southern Madagascar where TB prevalence, poverty and food insecurity rates are high. We aimed to determine facilitators and barriers to access to and provision of TB care in rural Madagascar during the COVID-19 pandemic.

Methods: We conducted qualitative focus group discussions (FGDs) and in-depth interviews (IDIs) with patients with TB, community health workers, facility-based health workers, public health officials and non-governmental organisation staff. We analysed interviews using thematic analysis.

Results: We conducted 11 FGDs and 23 IDIs. We identified three main barriers to access and adherence to TB care: 1) stigma, 2) indirect treatment costs, and 3) food insecurity. The facilitator perceived as most influential was high health worker motivation. The effects of the COVID-19 pandemic on TB care varied between stake-holders; some health workers described delays in TB diagnosis and increased workload.

Conclusions: To improve access and adherence to TB care, both indirect treatment costs and stigma need to be reduced; undernourished patients with TB should receive food support.

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COVID-19大流行期间结核病治疗的促进因素和障碍。

背景:在资源有限的环境中，关于结核病治疗可及性和坚持性的影响因素以及COVID-19大流行对结核病治疗的影响的知识很少。我们在Atsimo-Andrefana进行了这项研究，这是马达加斯加南部的一个农村地区，结核病患病率、贫困率和粮食不安全率都很高。我们的目的是确定COVID-19大流行期间马达加斯加农村地区获得和提供结核病治疗的促进因素和障碍。方法:我们对结核病患者、社区卫生工作者、设施卫生工作者、公共卫生官员和非政府组织工作人员进行了定性焦点小组讨论(fgd)和深度访谈(IDIs)。我们使用主题分析来分析访谈。结果:共进行fgd 11例，IDIs 23例。我们确定了获得和坚持结核病治疗的三个主要障碍:1)耻辱，2)间接治疗费用，以及3)粮食不安全。被认为最有影响力的促进因素是卫生工作者的积极性很高。COVID-19大流行对结核病治疗的影响因利益攸关方而异;一些卫生工作者描述了结核病诊断的延误和工作量的增加。结论:为了改善结核病治疗的可及性和依从性，需要减少间接治疗费用和污名;营养不良的结核病患者应得到食物支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.