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Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study
INTRODUCTION: Patients with Tuberculosis (TB) still have barriers in accessing high quality care and treatment services. In this qualitative study, we investigated barriers in accessing TB health services including confirmatory diagnosis, treatment adherence and recurrence of pulmonary TB using pati...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982675/ https://www.ncbi.nlm.nih.gov/pubmed/36874622 http://dx.doi.org/10.1016/j.jctube.2023.100353 |
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author | Rahmati, Shoboo Nasehi, Mahshid Bahrampour, Abbas Mirzazadeh, Ali Shahesmaeili, Armita |
author_facet | Rahmati, Shoboo Nasehi, Mahshid Bahrampour, Abbas Mirzazadeh, Ali Shahesmaeili, Armita |
author_sort | Rahmati, Shoboo |
collection | PubMed |
description | INTRODUCTION: Patients with Tuberculosis (TB) still have barriers in accessing high quality care and treatment services. In this qualitative study, we investigated barriers in accessing TB health services including confirmatory diagnosis, treatment adherence and recurrence of pulmonary TB using patients, physicians, and policy makers point of view. MATERIALS AND METHODS: In this qualitative research from November to March 2021, 3 policy makers from the Ministry of Health, 12 provincial TB experts and physicians from the TB control program and 33 patients diagnosed with TB from 4 provinces were enrolled for a semi-structured in-depth interview. All interviews were audio recorded and then transcribed. Framework analysis was done by MAXQDA 2018 software to identify key themes. RESULTS: Several barriers reported for TB care and treatment: Poor knowledge of patents about TB symptoms, failure to screen for TB among at-risk patients by physicians, similar symptoms between TB and other lung diseases, low sensitivity of TB diagnostic tests, incomplete case finding and contact-tracing, stigma related to TB, and patients poor adherence due to long TB treatment. In addition, COVID-19 pandemic disrupted TB services and decreased detection, care and treatment services for TB patients. CONCLUSION: Our findings highlight the need for interventions to increase public and healthcare providers awareness about TB symptoms, using more sensitive diagnostic tests, and interventions to reduce stigma, and improve case finding and contact tracing effort. Improving patients’ adherence required better monitoring and shorter effective treatment regimes. |
format | Online Article Text |
id | pubmed-9982675 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-99826752023-03-04 Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study Rahmati, Shoboo Nasehi, Mahshid Bahrampour, Abbas Mirzazadeh, Ali Shahesmaeili, Armita J Clin Tuberc Other Mycobact Dis Article INTRODUCTION: Patients with Tuberculosis (TB) still have barriers in accessing high quality care and treatment services. In this qualitative study, we investigated barriers in accessing TB health services including confirmatory diagnosis, treatment adherence and recurrence of pulmonary TB using patients, physicians, and policy makers point of view. MATERIALS AND METHODS: In this qualitative research from November to March 2021, 3 policy makers from the Ministry of Health, 12 provincial TB experts and physicians from the TB control program and 33 patients diagnosed with TB from 4 provinces were enrolled for a semi-structured in-depth interview. All interviews were audio recorded and then transcribed. Framework analysis was done by MAXQDA 2018 software to identify key themes. RESULTS: Several barriers reported for TB care and treatment: Poor knowledge of patents about TB symptoms, failure to screen for TB among at-risk patients by physicians, similar symptoms between TB and other lung diseases, low sensitivity of TB diagnostic tests, incomplete case finding and contact-tracing, stigma related to TB, and patients poor adherence due to long TB treatment. In addition, COVID-19 pandemic disrupted TB services and decreased detection, care and treatment services for TB patients. CONCLUSION: Our findings highlight the need for interventions to increase public and healthcare providers awareness about TB symptoms, using more sensitive diagnostic tests, and interventions to reduce stigma, and improve case finding and contact tracing effort. Improving patients’ adherence required better monitoring and shorter effective treatment regimes. Elsevier 2023-02-16 /pmc/articles/PMC9982675/ /pubmed/36874622 http://dx.doi.org/10.1016/j.jctube.2023.100353 Text en © 2023 Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Rahmati, Shoboo Nasehi, Mahshid Bahrampour, Abbas Mirzazadeh, Ali Shahesmaeili, Armita Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study |
title | Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study |
title_full | Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study |
title_fullStr | Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study |
title_full_unstemmed | Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study |
title_short | Barriers and gaps in tuberculosis care and treatment in Iran: A multi-center qualitative study |
title_sort | barriers and gaps in tuberculosis care and treatment in iran: a multi-center qualitative study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982675/ https://www.ncbi.nlm.nih.gov/pubmed/36874622 http://dx.doi.org/10.1016/j.jctube.2023.100353 |
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