Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries
Abstract Background The End TB Strategy calls for global scale-up of preventive treatment for latent tuberculosis infection (LTBI), but little information is available about the associated human resource requirements. Our study aimed to quantify the healthcare worker (HCW) time needed to perform the...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05220-7 |
| _version_ | 1818506998073786368 |
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| author | H. Alsdurf O. Oxlade M. Adjobimey F. Ahmad Khan M. Bastos N. Bedingfield A. Benedetti D. Boafo T. N. Buu L. Chiang V. Cook D. Fisher G. J. Fox F. Fregonese P. Hadisoemarto J. C. Johnston F. Kassa R. Long S. Moayedi Nia T. A. Nguyen J. Obeng C. Paulsen K. Romanowski R. Ruslami K. Schwartzman H. Sohn E. Strumpf A. Trajman C. Valiquette L. Yaha D. Menzies |
| author_facet | H. Alsdurf O. Oxlade M. Adjobimey F. Ahmad Khan M. Bastos N. Bedingfield A. Benedetti D. Boafo T. N. Buu L. Chiang V. Cook D. Fisher G. J. Fox F. Fregonese P. Hadisoemarto J. C. Johnston F. Kassa R. Long S. Moayedi Nia T. A. Nguyen J. Obeng C. Paulsen K. Romanowski R. Ruslami K. Schwartzman H. Sohn E. Strumpf A. Trajman C. Valiquette L. Yaha D. Menzies |
| author_sort | H. Alsdurf |
| collection | DOAJ |
| description | Abstract Background The End TB Strategy calls for global scale-up of preventive treatment for latent tuberculosis infection (LTBI), but little information is available about the associated human resource requirements. Our study aimed to quantify the healthcare worker (HCW) time needed to perform the tasks associated with each step along the LTBI cascade of care for household contacts of TB patients. Methods We conducted a time and motion (TAM) study between January 2018 and March 2019, in which consenting HCWs were observed throughout a typical workday. The precise time spent was recorded in pre-specified categories of work activities for each step along the cascade. A linear mixed model was fit to estimate the time at each step. Results A total of 173 HCWs in Benin, Canada, Ghana, Indonesia, and Vietnam participated. The greatest amount of time was spent for the medical evaluation (median: 11 min; IQR: 6–16), while the least time was spent on reading a tuberculin skin test (TST) (median: 4 min; IQR: 2–9). The greatest variability was seen in the time spent for each medical evaluation, while TST placement and reading showed the least variability. The total time required to complete all steps along the LTBI cascade, from identification of household contacts (HHC) through to treatment initiation ranged from 1.8 h per index TB patient in Vietnam to 5.2 h in Ghana. Conclusions Our findings suggest that the time requirements are very modest to perform each step in the latent TB cascade of care, but to achieve full identification and management of all household contacts will require additional human resources in many settings. |
| first_indexed | 2024-12-10T22:12:31Z |
| format | Article |
| id | doaj.art-32dc918f10384d58b97304bab2e98409 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-10T22:12:31Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-32dc918f10384d58b97304bab2e984092022-12-22T01:31:33ZengBMCBMC Health Services Research1472-69632020-04-0120111110.1186/s12913-020-05220-7Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countriesH. Alsdurf0O. Oxlade1M. Adjobimey2F. Ahmad Khan3M. Bastos4N. Bedingfield5A. Benedetti6D. Boafo7T. N. Buu8L. Chiang9V. Cook10D. Fisher11G. J. Fox12F. Fregonese13P. Hadisoemarto14J. C. Johnston15F. Kassa16R. Long17S. Moayedi Nia18T. A. Nguyen19J. Obeng20C. Paulsen21K. Romanowski22R. Ruslami23K. Schwartzman24H. Sohn25E. Strumpf26A. Trajman27C. Valiquette28L. Yaha29D. Menzies30Department of Epidemiology, Biostatistics and Occupational Health, McGill UniversityMcGill International TB Centre, McGill UniversityProgramme National contre la Tuberculose-Bénin, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie-CotonouMcGill International TB Centre, McGill UniversityRespiratory Epidemiology and Clinical Research Unit (RECRU), McGill UniversityUniversity of CalgaryDepartment of Epidemiology, Biostatistics and Occupational Health, McGill UniversityChest Clinic, Komfo Anokye Teaching HospitalWoolcock Institute of Medical ResearchProvincial Tuberculosis Services, British Columbia Centre for Disease ControlProvincial Tuberculosis Services, British Columbia Centre for Disease ControlDivision of Respiratory Medicine, University of CalgaryThe Faculty of Medicine and Health, The University of Sydney Central Clinical School, The University of SydneyMcGill International TB Centre, McGill UniversityDepartment of Public Health, Faculty of Medicine, TB-HIV Research Center, Universitas PadjadjaranProvincial Tuberculosis Services, British Columbia Centre for Disease ControlProgramme National contre la Tuberculose-Bénin, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie-CotonouDepartment of Medicine, Faculty of Medicine and Dentistry, University of AlbertaDepartment of Social and Preventive Medicine, Université de MontréalWoolcock Institute of Medical ResearchChest Clinic, Komfo Anokye Teaching HospitalDepartment of Medicine, Faculty of Medicine and Dentistry, University of AlbertaProvincial Tuberculosis Services, British Columbia Centre for Disease ControlDepartment of Biomedical Sciences, Division of Pharmacology & Therapy, Faculty of Medicine, Universitas PadjadjaranDepartment of Epidemiology, Biostatistics and Occupational Health, McGill UniversityDepartment of Epidemiology, John Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Biostatistics and Occupational Health, McGill UniversitySocial Medicine Institute, State University of Rio de JaneiroMcGill International TB Centre, McGill UniversityProgramme National contre la Tuberculose-Bénin, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie-CotonouDepartment of Epidemiology, Biostatistics and Occupational Health, McGill UniversityAbstract Background The End TB Strategy calls for global scale-up of preventive treatment for latent tuberculosis infection (LTBI), but little information is available about the associated human resource requirements. Our study aimed to quantify the healthcare worker (HCW) time needed to perform the tasks associated with each step along the LTBI cascade of care for household contacts of TB patients. Methods We conducted a time and motion (TAM) study between January 2018 and March 2019, in which consenting HCWs were observed throughout a typical workday. The precise time spent was recorded in pre-specified categories of work activities for each step along the cascade. A linear mixed model was fit to estimate the time at each step. Results A total of 173 HCWs in Benin, Canada, Ghana, Indonesia, and Vietnam participated. The greatest amount of time was spent for the medical evaluation (median: 11 min; IQR: 6–16), while the least time was spent on reading a tuberculin skin test (TST) (median: 4 min; IQR: 2–9). The greatest variability was seen in the time spent for each medical evaluation, while TST placement and reading showed the least variability. The total time required to complete all steps along the LTBI cascade, from identification of household contacts (HHC) through to treatment initiation ranged from 1.8 h per index TB patient in Vietnam to 5.2 h in Ghana. Conclusions Our findings suggest that the time requirements are very modest to perform each step in the latent TB cascade of care, but to achieve full identification and management of all household contacts will require additional human resources in many settings.http://link.springer.com/article/10.1186/s12913-020-05220-7Latent tuberculosis infectionCascade-of-careTime and motion study |
| spellingShingle | H. Alsdurf O. Oxlade M. Adjobimey F. Ahmad Khan M. Bastos N. Bedingfield A. Benedetti D. Boafo T. N. Buu L. Chiang V. Cook D. Fisher G. J. Fox F. Fregonese P. Hadisoemarto J. C. Johnston F. Kassa R. Long S. Moayedi Nia T. A. Nguyen J. Obeng C. Paulsen K. Romanowski R. Ruslami K. Schwartzman H. Sohn E. Strumpf A. Trajman C. Valiquette L. Yaha D. Menzies Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries BMC Health Services Research Latent tuberculosis infection Cascade-of-care Time and motion study |
| title | Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries |
| title_full | Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries |
| title_fullStr | Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries |
| title_full_unstemmed | Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries |
| title_short | Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries |
| title_sort | resource implications of the latent tuberculosis cascade of care a time and motion study in five countries |
| topic | Latent tuberculosis infection Cascade-of-care Time and motion study |
| url | http://link.springer.com/article/10.1186/s12913-020-05220-7 |
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