Cargando…
Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives
BACKGROUND: Since 2018, over 14 million people have been treated for tuberculosis (TB) globally. However, pre-treatment loss to follow-up (PTLFU) has been shown to contribute substantially to patient losses in the TB care cascade with subsequent high community transmission and mortality rates. OBJEC...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788701/ https://www.ncbi.nlm.nih.gov/pubmed/36548521 http://dx.doi.org/10.1080/16549716.2022.2148355 |
_version_ | 1784858813045669888 |
---|---|
author | Mulaku, Mercy Namuma Nyagol, Bruce Owino, Eddy Johnson Ochodo, Eleanor Young, Taryn Steingart, Karen R |
author_facet | Mulaku, Mercy Namuma Nyagol, Bruce Owino, Eddy Johnson Ochodo, Eleanor Young, Taryn Steingart, Karen R |
author_sort | Mulaku, Mercy Namuma |
collection | PubMed |
description | BACKGROUND: Since 2018, over 14 million people have been treated for tuberculosis (TB) globally. However, pre-treatment loss to follow-up (PTLFU) has been shown to contribute substantially to patient losses in the TB care cascade with subsequent high community transmission and mortality rates. OBJECTIVE: To identify, appraise, and synthesise evidence on the perspectives of patients and healthcare workers on factors contributing to PTLFU in adults with pulmonary TB. METHODS: We registered the title with PROSPERO (CRD42021253212). We searched nine relevant databases up to 24 May 2021 for qualitative studies. Two review authors independently reviewed records for eligibility and extracted data. We assessed methodological quality with the Evidence for Policy and Practice Information Centre tool and synthesised data using the Supporting the Use of Research Evidence framework. We assessed confidence in our findings using Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual). RESULTS: We reviewed a total of 1239 records and included five studies, all from low- and middle-income countries. Key themes reported by patients and healthcare workers were communication challenges among healthcare workers and between healthcare workers and patients; knowledge, attitudes, and behaviours about TB and its management; accessibility and availability of facilities for TB care; and human resource and financial constraints, weakness in management and leadership in TB programmes. Patients’ change of residence, long waiting times, and poor referral systems were additional factors that contributed to patients disengaging from care. We had moderate confidence in most of our findings. CONCLUSION: Findings from our qualitative evidence synthesis highlight multiple factors that contribute to PTLFU. Central to addressing these factors will be the need to strengthen health systems and offer people-centred care. |
format | Online Article Text |
id | pubmed-9788701 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-97887012022-12-24 Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives Mulaku, Mercy Namuma Nyagol, Bruce Owino, Eddy Johnson Ochodo, Eleanor Young, Taryn Steingart, Karen R Glob Health Action Review Article BACKGROUND: Since 2018, over 14 million people have been treated for tuberculosis (TB) globally. However, pre-treatment loss to follow-up (PTLFU) has been shown to contribute substantially to patient losses in the TB care cascade with subsequent high community transmission and mortality rates. OBJECTIVE: To identify, appraise, and synthesise evidence on the perspectives of patients and healthcare workers on factors contributing to PTLFU in adults with pulmonary TB. METHODS: We registered the title with PROSPERO (CRD42021253212). We searched nine relevant databases up to 24 May 2021 for qualitative studies. Two review authors independently reviewed records for eligibility and extracted data. We assessed methodological quality with the Evidence for Policy and Practice Information Centre tool and synthesised data using the Supporting the Use of Research Evidence framework. We assessed confidence in our findings using Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual). RESULTS: We reviewed a total of 1239 records and included five studies, all from low- and middle-income countries. Key themes reported by patients and healthcare workers were communication challenges among healthcare workers and between healthcare workers and patients; knowledge, attitudes, and behaviours about TB and its management; accessibility and availability of facilities for TB care; and human resource and financial constraints, weakness in management and leadership in TB programmes. Patients’ change of residence, long waiting times, and poor referral systems were additional factors that contributed to patients disengaging from care. We had moderate confidence in most of our findings. CONCLUSION: Findings from our qualitative evidence synthesis highlight multiple factors that contribute to PTLFU. Central to addressing these factors will be the need to strengthen health systems and offer people-centred care. Taylor & Francis 2022-12-22 /pmc/articles/PMC9788701/ /pubmed/36548521 http://dx.doi.org/10.1080/16549716.2022.2148355 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Mulaku, Mercy Namuma Nyagol, Bruce Owino, Eddy Johnson Ochodo, Eleanor Young, Taryn Steingart, Karen R Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
title | Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
title_full | Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
title_fullStr | Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
title_full_unstemmed | Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
title_short | Factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
title_sort | factors contributing to pre-treatment loss to follow-up in adults with pulmonary tuberculosis: a qualitative evidence synthesis of patient and healthcare worker perspectives |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788701/ https://www.ncbi.nlm.nih.gov/pubmed/36548521 http://dx.doi.org/10.1080/16549716.2022.2148355 |
work_keys_str_mv | AT mulakumercynamuma factorscontributingtopretreatmentlosstofollowupinadultswithpulmonarytuberculosisaqualitativeevidencesynthesisofpatientandhealthcareworkerperspectives AT nyagolbruce factorscontributingtopretreatmentlosstofollowupinadultswithpulmonarytuberculosisaqualitativeevidencesynthesisofpatientandhealthcareworkerperspectives AT owinoeddyjohnson factorscontributingtopretreatmentlosstofollowupinadultswithpulmonarytuberculosisaqualitativeevidencesynthesisofpatientandhealthcareworkerperspectives AT ochodoeleanor factorscontributingtopretreatmentlosstofollowupinadultswithpulmonarytuberculosisaqualitativeevidencesynthesisofpatientandhealthcareworkerperspectives AT youngtaryn factorscontributingtopretreatmentlosstofollowupinadultswithpulmonarytuberculosisaqualitativeevidencesynthesisofpatientandhealthcareworkerperspectives AT steingartkarenr factorscontributingtopretreatmentlosstofollowupinadultswithpulmonarytuberculosisaqualitativeevidencesynthesisofpatientandhealthcareworkerperspectives |