Chimbatata Nathan B W, Zhou Chang-Ming, Chimbatata Chikondi M, Xu Biao
School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Xuhui District, Shanghai, 200032, China.
Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China.
Infect Dis Poverty. 2017 May 11;6(1):60. doi: 10.1186/s40249-017-0279-1.
Malawi is a low-income country with high Tuberculosis (TB) burden. TB diagnosis delay and untimely initiation of treatment is still a major problem in Malawi which could increase the risk of tuberculosis transmission in the communities. This study investigated factors related to the diagnostic delay of tuberculosis from TB healthcare providers in the northern region of Malawi.
Nine focus group discussions were conducted with 57 participants in total. The participants were healthcare cadres including district TB officers, clinical officers, TB nurses, laboratory technicians and Health Surveillance Assistants (HSAs). NVivo (11.0) software was used for data analysis.
The factors related to diagnostic delay were categorized into three themes: client factors, institutional factors and healthcare provider related factors. Client's stigma and fear for HIV test, resource shortage within healthcare institutions and the healthcare workers' poor attitude against potential patients were among the most influential factors behind the TB diagnostic delay.
The TB control strategies should aim to reduce HIV stigma, improve resource supply and improve TB healthcare workers' morale in order to achieve timely TB diagnosis.
马拉维是一个结核病负担沉重的低收入国家。结核病诊断延误和治疗开始不及时仍是马拉维的一个主要问题,这可能会增加结核病在社区传播的风险。本研究调查了马拉维北部地区结核病医疗服务提供者中与结核病诊断延误相关的因素。
总共与57名参与者进行了9次焦点小组讨论。参与者为卫生保健人员,包括 district TB officers、临床医生、结核病护士、实验室技术人员和健康监测助理(HSAs)。使用NVivo(11.0)软件进行数据分析。
与诊断延误相关的因素分为三个主题:患者因素、机构因素和医疗服务提供者相关因素。患者的耻辱感和对艾滋病毒检测的恐惧、医疗机构内资源短缺以及医护人员对潜在患者的不良态度是结核病诊断延误背后最具影响力的因素。
结核病控制策略应旨在减少对艾滋病毒的耻辱感、改善资源供应并提高结核病医护人员的士气,以实现结核病的及时诊断。