ArticlePloS one2023
Understanding barriers to tuberculosis diagnosis and treatment completion in a low-resource setting: A mixed-methods study in the Kingdom of Lesotho.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers That Interfere with Access to Tuberculosis Diagnosis and Treatment across Countries Globally: A Systematic Review.ACS infectious diseases · 2024Pooled it
- Diagnostic Performance of the Pluslife MiniDock MTB and Molbio MTB Ultima Assays to Detect Tuberculosis From Tongue and Sputum Swabs Among Outpatients and in Active Case Finding in Cameroon.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Stakeholder engagement to identify barriers to implementation and inform the development of point-of-care diagnostics for TB.IJTLD open · 2026Article
- Tuberculosis screening and care delivery in pregnant and postpartum persons living with HIV in Botswana.PLOS global public health · 2026Article
- Article
- Tuberculosis- learning about experience with nutritional supplementation (TB LENS): Perspectives on a nutritional supplementation for persons with TB and their household contacts.Global public health · 2025Article
- Using sputum and tongue swab specimens for in-home point-of-care targeted universal testing for tuberculosis of household contacts: an acceptability and feasibility analysis.BMJ global health · 2025Article
- Social isolation, social exclusion, and access to mental and tangible resources: mapping the gendered impact of tuberculosis-related stigma among men and women living with tuberculosis in Eastern Cape Province, South Africa.BMC global and public health · 2025Article
- Article
- AI-Y: An AI Checklist for Population Ethics Across the Global Context.Current epidemiology reports · 2025Review
- Nutritionally acquired immunodeficiency must be addressed with the same urgency as HIV to end tuberculosis.BMC global and public health · 2024Review
- Tuberculosis commodities supply chain performance in the WHO African region: A scoping review.PLOS global public health · 2024Article
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Authors and funding
10 authors.
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Abstract
backgroundLesotho is one of the 30 countries with the highest tuberculosis incidence rates in the world, estimated at 650 per 100,000 population. Tuberculosis case detection is extremely low, particularly with the rapid spread of COVID-19, dropping from an estimated 51% in 2020 to 33% in 2021. The aim of this study is to understand the barriers to tuberculosis diagnosis and treatment completion.
methodsWe used a convergent mixed methods study design. We collected data on the number of clients reporting symptoms upon tuberculosis screening, their sputum test results, the number of clients diagnosed, and the number of clients who started treatment from one district hospital and one health center in Berea district, Lesotho. We conducted in-depth interviews and focus group discussions with 53 health workers and patients. We used a content analysis approach to analyze qualitative data and integrated quantitative and qualitative findings in a joint display.
findingsDuring March-August, 2019, 218 clients at the hospital and 292 clients at the health center reported tuberculosis symptoms. The full diagnostic testing process was completed for 66% of clients at the hospital and 68% at the health center. Among clients who initiated tuberculosis treatment, 68% (61/90) at the hospital and 74% (32/43) at the health center completed treatment. The main barriers to testing and treatment completion were challenges at sample collection, lack of decentralized diagnostic services, and socioeconomic factors such as food insecurity and high patient movement to search for jobs.
conclusionsTuberculosis diagnosis could be improved through the effective decentralization of laboratory services at the health facility level, and treatment completion could be improved by providing food and other forms of social support to patients.
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