ArticlePublic health action2022
Facilitators and barriers to TB care during the COVID-19 pandemic.
Article in Public health action, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Mediating Role of Depression and Anxiety in the Association Between Food Insecurity and Delayed TB Treatment in Botswana: A Cross-Sectional Study.medRxiv : the preprint server for health sciences · 2026Article
- Community-based mobile tuberculosis clinics in rural Madagascar: impact and cost-effectiveness analysis.BMJ global health · 2025Article
- Perceptions of tuberculosis and home-based infection screening among families and providers in Madagascar: a qualitative study.BMC public health · 2025Article
- Factors Associated With Low Tuberculosis Case Detection and Investigation in Public Health Facilities (PHFs) in Bududa District, Uganda: A Cross-Sectional Study.Health science reports · 2025Article
- The impact of the COVID-19 pandemic on tuberculosis treatment outcomes in 49 high burden countries.BMC medicine · 2024Article
- A cross-sectional analysis of the effectiveness of a nutritional support programme for people with tuberculosis in Southern Madagascar using secondary data from a non-governmental organisation.Infectious diseases of poverty · 2024Article
- Patient level barriers to accessing TB care services during the COVID-19 pandemic in Uganda, a mixed methods study.BMC health services research · 2024Article
- Article
- Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis.European respiratory review : an official journal of the European Respiratory Society · 2023Review
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Authors and funding
11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundKnowledge about factors influencing access and adherence to TB care, and on the impact of the COVID-19 pandemic on TB care in resource-restricted settings is scarce. We conducted this study in Atsimo-Andrefana, a rural region in southern Madagascar where TB prevalence, poverty and food insecurity rates are high. We aimed to determine facilitators and barriers to access to and provision of TB care in rural Madagascar during the COVID-19 pandemic.
methodsWe conducted qualitative focus group discussions (FGDs) and in-depth interviews (IDIs) with patients with TB, community health workers, facility-based health workers, public health officials and non-governmental organisation staff. We analysed interviews using thematic analysis.
resultsWe conducted 11 FGDs and 23 IDIs. We identified three main barriers to access and adherence to TB care: 1) stigma, 2) indirect treatment costs, and 3) food insecurity. The facilitator perceived as most influential was high health worker motivation. The effects of the COVID-19 pandemic on TB care varied between stake-holders; some health workers described delays in TB diagnosis and increased workload.
conclusionsTo improve access and adherence to TB care, both indirect treatment costs and stigma need to be reduced; undernourished patients with TB should receive food support.
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