Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Microbiology, Unit for Genome Dynamics, University of Oslo, Oslo, Norway.
PLoS One. 2019 Nov 13;14(11):e0224277. doi: 10.1371/journal.pone.0224277. eCollection 2019.
Drug-resistant tuberculosis (DR-TB) remains a major health security threat worldwide. The effectiveness of implementation of DR-TB control strategies has been a subject of research and controversy. In resource-limited settings, using conventional medicine as the only framework to explain DR-TB gives a rather incomplete picture of the disease. This study intended to explore the perceptions and experiences of healthcare workers on the management and control of DR-TB in Addis Ababa, Ethiopia.
The study employed a qualitative methodology with an inductive approach and a thematic analysis. It involved in-depth interviews with healthcare workers providing clinical services to DR-TB patients in 10 public healthcare facilities in Addis Ababa, Ethiopia.
A total of 18 healthcare workers participated until data saturation, which included 12 clinical nurses, four health officers and two medical laboratory technicians. The findings show that healthcare workers perceive DR-TB as a growing public health threat in Ethiopia, due to factors such as poverty, poor nutrition, crowded settings, healthcare worker and general public awareness of DR-TB, lack of good governance and culture.
The perspectives drawn from the healthcare workers shed more light on the image of DR-TB in a developing country context. It has been shown that understanding DR-TB is not confined to what can be drawn from the sphere of biomedicine. There are also interconnected barriers, which predict a dystopia in the epidemiology of DR-TB. Bringing DR-TB under control requires taking a step back from an overwhelming focus on the biomedical facets of the disease, and employ critical thinking on the wider social and structural forces as equally important targets.
耐药结核病（DR-TB）仍然是全球主要的卫生安全威胁。DR-TB 控制策略的实施效果一直是研究和争议的主题。在资源有限的环境中，仅将传统医学作为解释 DR-TB 的唯一框架，对该疾病的描述并不完整。本研究旨在探讨埃塞俄比亚亚的斯亚贝巴的卫生保健工作者对 DR-TB 管理和控制的看法和经验。
该研究采用定性方法，采用归纳法和主题分析。它涉及在埃塞俄比亚亚的斯亚贝巴的 10 家公立医疗机构中为 DR-TB 患者提供临床服务的卫生保健工作者进行深入访谈。
共有 18 名卫生保健工作者参与了研究，直到数据饱和，其中包括 12 名临床护士、4 名卫生官员和 2 名医学实验室技术员。研究结果表明，卫生保健工作者认为 DR-TB 是埃塞俄比亚日益严重的公共卫生威胁，原因包括贫困、营养不良、拥挤的环境、卫生保健工作者和公众对 DR-TB 的认识、良好治理和文化的缺乏。
从卫生保健工作者的角度来看，DR-TB 在发展中国家的形象更加清晰。研究表明，对 DR-TB 的理解不仅限于从生物医学领域得出的结论。还存在相互关联的障碍，这预示着 DR-TB 的流行病学将陷入困境。控制 DR-TB 需要从对疾病生物医学方面的过度关注中退后一步，并对更广泛的社会和结构力量进行批判性思考，将其视为同样重要的目标。
