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埃塞俄比亚耐多药结核病的预防与控制:奥罗米亚地区患者的观点

Prevention and control of multidrug-resistance tuberculosis in Ethiopia: Patients' perspectives from the Oromia region.

作者信息

Beyene Reta Angessa, Janse van Rensburg Elsie

机构信息

Department of Health Studies, University of South Africa (UNISA), Pretoria, South Africa.

出版信息

PLoS One. 2025 May 12;20(5):e0322054. doi: 10.1371/journal.pone.0322054. eCollection 2025.

Abstract

BACKGROUND

Multi-drug-resistant tuberculosis (MDR-TB) is one of the biggest challenges worldwide to end tuberculosis. It is vital to understand the challenges and opportunities of patients during MDR-TB treatment to enhance prevention and control efforts. The gap in research on the challenges and opportunities of patients during the screening, diagnosis, referral, and follow-up of MDR-TB prompted this study.

PURPOSE

The purpose of the study was to assess the challenges and opportunities for patients with MDR-TB during the diagnosis and treatment of MDR-TB in the Oromia region of Ethiopia.

METHODS

A qualitative approach was applied. The data were collected from 30 MDR-TB patients from 1 to 30 April 2022 using semi-structured interviews after written informed consent was signed by each participant to understand the challenges and opportunities of MDR-TB treatment. Data was analysed by thematic analysis using ATLAS.ti software.

RESULT

This article identifies challenges that include delays in diagnosis and treatment initiation due to inadequate diagnostic services, physical inaccessibility, and financial problems faced by patients to pay for transport, food, diagnosis, and accommodation. Other challenges included lack of psychosocial support, shortage of healthcare providers, poor communication, drug side effects, and interruption of food and housing support. In addition, participants mentioned opportunities, which include the availability of free diagnosis, treatment, and admission; availability of transport; food and housing allowance; and use of an ambulance for referral.

CONCLUSION

This study filled a research gap in Ethiopia by identifying challenges and opportunities during the MDR-TB treatment program. The MDR-TB treatment program should focus on improving inadequate screening and resources, shortage of healthcare providers, delays in the referral process, and non-compliance of patients.

摘要

背景

耐多药结核病(MDR-TB)是全球终结结核病面临的最大挑战之一。了解耐多药结核病患者在治疗期间面临的挑战和机遇对于加强防控工作至关重要。耐多药结核病筛查、诊断、转诊和随访期间患者面临的挑战和机遇方面的研究空白促使了本研究的开展。

目的

本研究的目的是评估埃塞俄比亚奥罗米亚地区耐多药结核病患者在耐多药结核病诊断和治疗期间面临的挑战和机遇。

方法

采用定性研究方法。2022年4月1日至30日,在每位参与者签署书面知情同意书后,通过半结构式访谈从30例耐多药结核病患者中收集数据,以了解耐多药结核病治疗的挑战和机遇。使用ATLAS.ti软件通过主题分析对数据进行分析。

结果

本文确定的挑战包括:由于诊断服务不足、交通不便以及患者支付交通、食物、诊断和住宿费用时面临的经济问题,导致诊断和治疗开始延迟。其他挑战包括缺乏心理社会支持、医疗服务提供者短缺、沟通不畅、药物副作用以及食物和住房支持中断。此外,参与者提到了一些机遇,包括免费诊断、治疗和住院;交通便利;食物和住房补贴;以及使用救护车进行转诊。

结论

本研究通过确定耐多药结核病治疗项目期间的挑战和机遇,填补了埃塞俄比亚的一项研究空白。耐多药结核病治疗项目应侧重于改善筛查不足和资源短缺、医疗服务提供者短缺、转诊过程延迟以及患者不依从的问题。

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本文引用的文献

1
Drug Resistance in Ethiopia: An Updated Systematic Review and Meta-Analysis.
Trop Med Infect Dis. 2022 Oct 14;7(10):300. doi: 10.3390/tropicalmed7100300.
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Treatment outcomes of patients with MDR-TB and its determinants at referral hospitals in Ethiopia.
PLoS One. 2022 Feb 17;17(2):e0262318. doi: 10.1371/journal.pone.0262318. eCollection 2022.
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Qual Health Res. 2022 Jan;32(1):159-167. doi: 10.1177/10497323211049777. Epub 2021 Nov 30.
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Attrition and delays before treatment initiation among patients with MDR-TB in China (2006-13): Magnitude and risk factors.
PLoS One. 2019 Apr 8;14(4):e0214943. doi: 10.1371/journal.pone.0214943. eCollection 2019.

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