TY - JOUR
T1 - Qualitative study of perceived causes of tuberculosis treatment default among health care workers in Morocco
AU - Kizub, D.
AU - Ghali, I.
AU - Sabouni, R.
AU - Bourkadi, J. E.
AU - Bennani, K.
AU - El Aouad, R.
AU - Dooley, Kelly E.
PY - 2012/9/1
Y1 - 2012/9/1
N2 - 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.
AB - 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.
KW - Health care professionals
KW - Morocco
KW - Qualitative research
KW - Treatment default
KW - Tuberculosis
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U2 - 10.5588/ijtld.11.0626
DO - 10.5588/ijtld.11.0626
M3 - Article
C2 - 22793783
AN - SCOPUS:84865261812
SN - 1027-3719
VL - 16
SP - 1214
EP - 1220
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 9
ER -