Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho
Lesotho has one of the highest tuberculosis (TB) incidence rates in the world, estimated at 654/100,000 population. However, TB detection remains low, with only 51% of people with TB being diagnosed and treated. The aim of this study was to evaluate implementation of TB screening and identify driver...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021370/?tool=EBI |
| _version_ | 1797700108593135616 |
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| author | Afom T. Andom Hannah N. Gilbert Melino Ndayizigiye Joia S. Mukherjee Jonase Nthunya Tholoana A. Marole Mary C. Smith Fawzi Courtney M. Yuen |
| author_facet | Afom T. Andom Hannah N. Gilbert Melino Ndayizigiye Joia S. Mukherjee Jonase Nthunya Tholoana A. Marole Mary C. Smith Fawzi Courtney M. Yuen |
| author_sort | Afom T. Andom |
| collection | DOAJ |
| description | Lesotho has one of the highest tuberculosis (TB) incidence rates in the world, estimated at 654/100,000 population. However, TB detection remains low, with only 51% of people with TB being diagnosed and treated. The aim of this study was to evaluate implementation of TB screening and identify drivers of suboptimal TB screening in Lesotho. We used a convergent mixed methods study design. We collected data on the number of health facility visits and the number of clients screened for TB during March-August, 2019 from one district hospital and one health center. We conducted interviews and focus group discussions with patients and health workers to elucidate the mechanisms associated with suboptimal screening. Out of an estimated 70,393 visitors to the two health facilities, only 22% of hospital visitors and 48% of health center visitors were asked about TB symptoms. Only 2% of those screened at each facility said that they had TB symptoms, comprising a total of 510 people. Lack of training on tuberculosis screening, overall staff shortages, barriers faced by patients in accessing care, and health care worker mistrust of tuberculosis screening procedures were identified as drivers of suboptimal TB screening. TB screening could be improved by ensuring the availability of well-trained, incentivized, and dedicated screeners at health facilities, and by providing TB screening services in community settings. |
| first_indexed | 2024-03-12T04:17:16Z |
| format | Article |
| id | doaj.art-a4c6d40e224142d393f5664465cba195 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T04:17:16Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-a4c6d40e224142d393f5664465cba1952023-09-03T10:35:18ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0123Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of LesothoAfom T. AndomHannah N. GilbertMelino NdayizigiyeJoia S. MukherjeeJonase NthunyaTholoana A. MaroleMary C. Smith FawziCourtney M. YuenLesotho has one of the highest tuberculosis (TB) incidence rates in the world, estimated at 654/100,000 population. However, TB detection remains low, with only 51% of people with TB being diagnosed and treated. The aim of this study was to evaluate implementation of TB screening and identify drivers of suboptimal TB screening in Lesotho. We used a convergent mixed methods study design. We collected data on the number of health facility visits and the number of clients screened for TB during March-August, 2019 from one district hospital and one health center. We conducted interviews and focus group discussions with patients and health workers to elucidate the mechanisms associated with suboptimal screening. Out of an estimated 70,393 visitors to the two health facilities, only 22% of hospital visitors and 48% of health center visitors were asked about TB symptoms. Only 2% of those screened at each facility said that they had TB symptoms, comprising a total of 510 people. Lack of training on tuberculosis screening, overall staff shortages, barriers faced by patients in accessing care, and health care worker mistrust of tuberculosis screening procedures were identified as drivers of suboptimal TB screening. TB screening could be improved by ensuring the availability of well-trained, incentivized, and dedicated screeners at health facilities, and by providing TB screening services in community settings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021370/?tool=EBI |
| spellingShingle | Afom T. Andom Hannah N. Gilbert Melino Ndayizigiye Joia S. Mukherjee Jonase Nthunya Tholoana A. Marole Mary C. Smith Fawzi Courtney M. Yuen Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho PLOS Global Public Health |
| title | Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho |
| title_full | Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho |
| title_fullStr | Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho |
| title_full_unstemmed | Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho |
| title_short | Understanding reasons for suboptimal tuberculosis screening in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho |
| title_sort | understanding reasons for suboptimal tuberculosis screening in a low resource setting a mixed methods study in the kingdom of lesotho |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021370/?tool=EBI |
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