Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia.
PLoS One. 2020 May 22;15(5):e0233358. doi: 10.1371/journal.pone.0233358. eCollection 2020.
Tuberculosis [TB] is the second leading cause of death from an infectious disease in the world. Intensifying tuberculosis screening and contact investigation strategy is recommended to ensure early diagnosis among household contacts of TB patients. Studies showed that there is low TB contact tracing. There was limited evidence on barriers and facilitators of household contact tracing. Therefore, this study was aimed at exploring barriers and facilitators for household contact tracing of index TB cases.
A descriptive qualitative study was conducted at Anlemo district, Hadiya zone, Ethiopia from March 12-April 9, 2019. Purposive sampling technique was used to recruit study participants. A total of 16 participants were involved in the study which included health extension workers [HEWs], index TB patients, household contacts of TB patients, health center TB focal and district TB coordinator. Data were collected through in-depth interviews using a semi-structured guide, transcribed verbatim and translated into English. Inductive thematic analysis was employed using ATLAS.ti7.1 software and the findings were presented on major themes, categories, and quotations.
This study found low TB contact tracing and investigation, and explored barriers and facilitators such as monitoring and supervision, training of health workers, logistics and infrastructure, waiting time and institutional readiness, referral, feedback and linkage, human resource, charge for some laboratory, transportation, budget, knowledge, commitment and motivation, workload, distance, social support, economic constrain, and stigma and discrimination for household contact tracing of index TB cases under four themes.
From this study, it was understood that there was a gap in addressing all household contacts. Also, the study explored a wide range of possible barriers and facilitators for it. Explored barriers outweigh the facilitators which might have an implication facilitating the dissemination of TB silently within the community. This underscores the importance of taking action to avert those barriers by developing different strategies to increase TB contact tracing. Therefore, health care providers should have to improve the implementation of contact tracing by designing and developing appropriate strategies that should fit the local context.
结核病（TB）是世界上第二大致死传染病。建议加强结核病筛查和接触者调查策略，以确保结核病患者的家庭接触者能够早期诊断。研究表明，结核病接触者追踪工作做得不够。关于家庭接触者追踪的障碍和促进因素的证据有限。因此，本研究旨在探讨家庭接触者追踪结核病例的障碍和促进因素。
2019 年 3 月 12 日至 4 月 9 日，在埃塞俄比亚哈迪亚地区的安莱莫区进行了一项描述性定性研究。采用目的抽样技术招募研究参与者。共有 16 名参与者参与了这项研究，包括卫生推广工作者[HEWs]、结核病例、结核病例的家庭接触者、卫生中心结核焦点和区结核协调员。通过使用半结构化指南进行深入访谈收集数据，逐字转录并翻译成英文。使用 ATLAS.ti7.1 软件进行归纳主题分析，主要主题、类别和引文呈现研究结果。
本研究发现结核病接触者追踪和调查工作做得不够，并探讨了监测和监督、卫生工作者培训、后勤和基础设施、等待时间和机构准备情况、转诊、反馈和联系、人力资源、一些实验室收费、交通、预算、知识、承诺和动机、工作量、距离、社会支持、经济限制以及对结核病例家庭接触者进行追踪的耻辱和歧视等障碍和促进因素，分为四个主题。
从这项研究中可以看出，在接触所有家庭接触者方面存在差距。此外，研究还探讨了广泛的可能障碍和促进因素。探索到的障碍大于促进因素，这可能意味着结核病在社区中悄然传播。这凸显了采取行动消除这些障碍的重要性，通过制定不同的策略来增加结核病接触者追踪。因此，医疗保健提供者应该通过设计和开发适合当地情况的适当策略来改进接触者追踪的实施。
