Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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Tuberculosis knowledge, attitudes and health-seeking behaviour among tuberculosis patients in Nelson Mandela Bay Municipality, sub district C, South Africa
- Authors: Onyango, Peggy
- Date: 2019
- Subjects: Tuberculosis
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16780 , vital:40773
- Description: The aim of this study was to examine the knowledge and attitude of Tuberculosis (TB) patients regarding TB disease, causes, treatment adherence and health seeking behaviour in Nelson Mandela Bay, sub district C, South Africa. A cross-sectional study was done in three community health centres in Nelson Mandela Bay Municipality sub district C, South Africa. It involved 327 respondents aged eighteen years and above who were on TB treatment for more than one month who were conveniently selected from the three clinics. 54.1% of the patients were males and 45.9% of the patients were females. A structured questionnaire was used to collect data. Frequency counts and percentages were used to analyse the data. Multivariate logistic regression analysis was used to examine the influence of demographic variables on the knowledge, attitude and health seeking behaviour towards TB. None of the demographic variables was statistically significant to determine the TB patients’ knowledge and attitude of TB disease, causes, treatment and adherence. Only housing was statistically significant (p<0.05) as a variable determining the knowledge of TB causes, treatment and adherence. Compared with the reference group (informal housing scheme), the knowledge of TB patients with formal housing scheme were 0.556 (95% CI: 0.316-0.977) higher to determine the correct knowledge. Spearman correlation was used to determine the statistical significance between knowledge-attitude (K-A), Knowledge-Health seeking behaviour (K-HSB) and attitude-health seeking behaviour (A-HSB). There was statistical significance association among the variables. Results show that TB knowledge was generally good amongst the TB clients. However, there was misconception that TB is caused by cold air, dust and that TB disease can change into HIV. More than half of the respondents felt that TB treatment is difficult, takes a long time, unpleasant and interferes with work /marriage. Health seeking behaviour was fair amongst the participants.
- Full Text:
- Authors: Onyango, Peggy
- Date: 2019
- Subjects: Tuberculosis
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16780 , vital:40773
- Description: The aim of this study was to examine the knowledge and attitude of Tuberculosis (TB) patients regarding TB disease, causes, treatment adherence and health seeking behaviour in Nelson Mandela Bay, sub district C, South Africa. A cross-sectional study was done in three community health centres in Nelson Mandela Bay Municipality sub district C, South Africa. It involved 327 respondents aged eighteen years and above who were on TB treatment for more than one month who were conveniently selected from the three clinics. 54.1% of the patients were males and 45.9% of the patients were females. A structured questionnaire was used to collect data. Frequency counts and percentages were used to analyse the data. Multivariate logistic regression analysis was used to examine the influence of demographic variables on the knowledge, attitude and health seeking behaviour towards TB. None of the demographic variables was statistically significant to determine the TB patients’ knowledge and attitude of TB disease, causes, treatment and adherence. Only housing was statistically significant (p<0.05) as a variable determining the knowledge of TB causes, treatment and adherence. Compared with the reference group (informal housing scheme), the knowledge of TB patients with formal housing scheme were 0.556 (95% CI: 0.316-0.977) higher to determine the correct knowledge. Spearman correlation was used to determine the statistical significance between knowledge-attitude (K-A), Knowledge-Health seeking behaviour (K-HSB) and attitude-health seeking behaviour (A-HSB). There was statistical significance association among the variables. Results show that TB knowledge was generally good amongst the TB clients. However, there was misconception that TB is caused by cold air, dust and that TB disease can change into HIV. More than half of the respondents felt that TB treatment is difficult, takes a long time, unpleasant and interferes with work /marriage. Health seeking behaviour was fair amongst the participants.
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