SETTING: In Morocco, tuberculosis (TB) treatment default is increasing in some urban areas. OBJECTIVE: To provide a detailed description of factors that contribute to patient default and solutions from the point of view of health care professionals who participate in TB care. DESIGN: In-depth interviews were conducted with 62 physicians and nurses at nine regional public pulmonary clinics and local health clinics. RESULTS: Participants had a median of 24 years of experience in health care. Treatment default was seen as a result of multilevel factors related to the patient (lack of means, being a migrant worker, distance to treatment site, poor understanding of treatment, drug use, mental illness), medical team (high patient load, low motivation, lack of resources for tracking defaulters), treatment organization (poor communication between treatment sites, no systematic strategy for patient education or tracking, incomplete record keeping), and health care system and society. Tailored recommendations for low- and higher-cost interventions are provided. CONCLUSIONS: Interventions to enhance TB treatment completion should take into account the local context and multilevel factors that contribute to default. Qualitative studies involving health care workers directly involved in TB care can be powerful tools to identify contributing factors and define strategies to help reduce treatment default.
SETTING: In Morocco, tuberculosis (TB) treatment default is increasing in some urban areas. OBJECTIVE: To provide a detailed description of factors that contribute to patient default and solutions from the point of view of health care professionals who participate in TB care. DESIGN: In-depth interviews were conducted with 62 physicians and nurses at nine regional public pulmonary clinics and local health clinics. RESULTS:Participants had a median of 24 years of experience in health care. Treatment default was seen as a result of multilevel factors related to the patient (lack of means, being a migrant worker, distance to treatment site, poor understanding of treatment, drug use, mental illness), medical team (high patient load, low motivation, lack of resources for tracking defaulters), treatment organization (poor communication between treatment sites, no systematic strategy for patient education or tracking, incomplete record keeping), and health care system and society. Tailored recommendations for low- and higher-cost interventions are provided. CONCLUSIONS: Interventions to enhance TB treatment completion should take into account the local context and multilevel factors that contribute to default. Qualitative studies involving health care workers directly involved in TB care can be powerful tools to identify contributing factors and define strategies to help reduce treatment default.
Authors: Maria Teresa Montagna; Christian Napoli; Silvio Tafuri; Antonella Agodi; Francesco Auxilia; Beatrice Casini; Maria Franca Coscia; Marcello Mario D'Errico; Margherita Ferrante; Angelo Fortunato; Cinzia Germinario; Domenico Martinelli; Giuseppe Michele Masanotti; Maria Fatima Massenti; Gabriele Messina; Paolo Montuori; Ida Mura; Giovanni Battista Orsi; Alessia Quaranta; Giovanni Sotgiu; Armando Stefanati; Stefano Tardivo; Maria Valeria Torregrossa; Anna Maria Tortorano; Licia Veronesi; Raffaele Zarrilli; Cesira Pasquarella Journal: BMC Public Health Date: 2014-09-18 Impact factor: 3.295
Authors: Imad Cherkaoui; Radia Sabouni; Iraqi Ghali; Darya Kizub; Alexander C Billioux; Kenza Bennani; Jamal Eddine Bourkadi; Abderrahmane Benmamoun; Ouafae Lahlou; Rajae El Aouad; Kelly E Dooley Journal: PLoS One Date: 2014-04-03 Impact factor: 3.240
Authors: Seup Park; Ilham Sentissi; Seung Jae Gil; Won-Seok Park; ByungKwon Oh; Ah Reum Son; Young Ju Kong; Sol Park; Eunseong Paek; Yong Joon Park; Seung Heon Lee Journal: Int J Environ Res Public Health Date: 2019-01-31 Impact factor: 3.390