Health Alliance International, Maputo, Mozambique.
The Mozambican National Tuberculosis Program, Maputo, Mozambique.
PLoS One. 2019 Jul 10;14(7):e0219470. doi: 10.1371/journal.pone.0219470. eCollection 2019.
Tuberculosis (TB) continues to be a leading cause of death in Sub-Saharan Africa, including Mozambique. While diagnostic methods and total notifications are improving, significant gaps remain between total numbers of TB cases annually, and the number that are notified. The purpose of this study was to elicit Mozambican patients with drug sensitive TB (DS-TB), TB/HIV and Multi drug resistant tuberculosis (MDR-TB) understanding and assessment of the quality of care for DS-TB, HIV/TB and MDR-TB services in Mozambique, along with challenges to effectively preventing, diagnosing and treating TB.
Qualitative data was collected via separate focus group discussions consisting of patients with DS-TB, TB/HIV and MDR-TB at four health centers in Sofala and Manica Province, Mozambique, to describe knowledge on TB, HIV and MDR-TB, and identify barriers to access and adherence to services and their recommendations for improvement. A total of 51 patients participated in 11 discussions. Content analysis was done and main themes were identified.
Focus groups shared a number of prominent themes. Respondents identified numerous challenges including delays in diagnosis, stigma related with diagnosis and treatment, long waits at health facilities, the absence of nutritional support for patients with TB, the absence of a comprehensive psychosocial support program, and the lack of overall knowledge about TB or multi drug resistant TB in the community.
TB patients in central Mozambique identified many challenges to effectively preventing, diagnosing and treating tuberculosis. Awareness strengthening in the community, continuous quality monitoring and in-service training is needed to increase screening, diagnosis and treatment for TB, HIV/TB and MDR-TB.
结核病(TB)仍然是撒哈拉以南非洲地区(包括莫桑比克)的主要死因。虽然诊断方法和总通报数正在改善,但每年结核病总病例数与通报病例数之间仍存在显著差距。本研究的目的是了解莫桑比克药物敏感型肺结核(DS-TB)、TB/HIV 和耐多药结核病(MDR-TB)患者的情况,并评估莫桑比克 DS-TB、HIV/TB 和 MDR-TB 服务的护理质量,以及有效预防、诊断和治疗结核病的挑战。
通过在莫桑比克索法拉省和马尼卡省的四个卫生中心进行的 11 次 DS-TB、TB/HIV 和 MDR-TB 患者单独焦点小组讨论,收集定性数据,以描述对 TB、HIV 和 MDR-TB 的了解,确定获得和坚持服务的障碍,并提出改进建议。共有 51 名患者参加了 11 次讨论。进行了内容分析并确定了主要主题。
焦点小组分享了一些突出的主题。受访者确定了许多挑战,包括诊断延迟、与诊断和治疗相关的耻辱感、在卫生设施长时间等待、TB 患者缺乏营养支持、缺乏全面的心理社会支持计划以及社区对 TB 或多药耐药性的整体知识缺乏。
莫桑比克中部的 TB 患者确定了在有效预防、诊断和治疗结核病方面面临的许多挑战。需要在社区中加强意识、持续进行质量监测和在职培训,以增加对 TB、HIV/TB 和 MDR-TB 的筛查、诊断和治疗。