Nhassengo Pedroso, Zandamela Américo, Nhamuave Celina, Cassy Sheyla Rodrigues, Chiau Rogério, Mutaquiha Cláudia, Zindoga Pereira, Manhiça Ivan, Khosa Celso, Cowan James
Instituto Nacional de Saúde, Marracuene, Moçambique.
Departamento de Matemática e Informática, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Moçambique.
BMC Glob Public Health. 2024 Feb 14;2(1):12. doi: 10.1186/s44263-024-00039-4.
In 2021, there were approximately 450,000 cases of drug-resistant tuberculosis (DR-TB) worldwide. The treatment of DR-TB historically included expensive and toxic injectable drugs leading to adverse effects including ototoxicity and Electrocardiogram (ECG) abnormalities. This study described the perspectives of healthcare providers and people with DR-TB on the usability of simplified audiometry and ECG for monitoring treatment adverse effects.
A qualitative study was conducted in December 2019 across four provinces in Mozambique, namely Maputo, Gaza, Zambézia, and Nampula. Sixteen outpatient primary care health facilities equipped with simplified Audiometry and/or ECG devices (specifically, SHOEBOX Audiometer® and/or SmartHeart Pro ECG®) installed for at least 6 months before the study initiation were selected. The data was collected using in-depth interviews (IDI) and Focus Group Discussions (FGD) techniques. Interviews were audio-recorded, transcribed verbatim in Portuguese, coded, and analyzed using Nvivo 12 software®. We generated two themes and fit our results into a conceptual framework consisting of three domains in the implementation of technological innovations in health.
A total of 16 healthcare providers and 91 people undergoing treatment for DR-TB were enrolled in the study. Most people with DR-TB had experienced audiometry testing and demonstrated a good understanding of the assessments. Conversely, while most healthcare providers demonstrated robust knowledge of the importance of both audiometry and ECG assessments, they were not confident in managing ECG devices and interpreting the results.
While healthcare providers demonstrated a consolidated understanding of the importance of audiometry, the limited number of devices and lack of training were constraints, impeding optimal usage and service delivery.
2021年，全球约有45万例耐多药结核病（DR-TB）病例。耐多药结核病的治疗历来包括使用昂贵且有毒的注射药物，会导致包括耳毒性和心电图（ECG）异常在内的不良反应。本研究描述了医疗服务提供者和耐多药结核病患者对简化听力测定和心电图用于监测治疗不良反应的可用性的看法。
2019年12月在莫桑比克的四个省份，即马普托、加扎、赞比西亚和楠普拉进行了一项定性研究。选择了16个配备简化听力测定仪和/或心电图设备（具体为SHOEBOX听力计®和/或SmartHeart Pro心电图®）且在研究开始前已安装至少6个月的门诊初级保健卫生设施。数据通过深入访谈（IDI）和焦点小组讨论（FGD）技术收集。访谈进行了录音，逐字转录为葡萄牙语，编码，并使用Nvivo 12软件®进行分析。我们生成了两个主题，并将我们的结果纳入一个由卫生技术创新实施中的三个领域组成的概念框架。
共有16名医疗服务提供者和91名正在接受耐多药结核病治疗的患者参与了该研究。大多数耐多药结核病患者都接受过听力测定测试，并对评估有很好的理解。相反，虽然大多数医疗服务提供者对听力测定和心电图评估的重要性表现出丰富的知识，但他们对管理心电图设备和解读结果缺乏信心。
虽然医疗服务提供者对听力测定的重要性表现出一致的理解，但设备数量有限和缺乏培训是限制因素，阻碍了最佳使用和服务提供。
