ArticleBMC infectious diseases2024
Health worker perspectives on barriers and facilitators of tuberculosis investigation coverage among index case contacts in rural Southwestern Uganda: a qualitative study.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- High two-month mortality in Gabonese adults with and without tuberculosis: A prospective cohort study of patients with presumed pulmonary tuberculosis.IJID regions · 2026Article
- Perceived benefits of community-based TB preventive treatment in children in Uganda: "When she sees other children getting the same medication, she will feel not alone."PLOS global public health · 2026Article
- Perceptions of tuberculosis and home-based infection screening among families and providers in Madagascar: a qualitative study.BMC public health · 2025Article
- The burden of tuberculosis and drug resistance in 22 Sub-Saharan African countries, 1990-2021: a GBD 2021 analysis and progress towards WHO 2035 targets with projections to 2050.Frontiers in microbiology · 2025Article
- Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: a quasi-experimental study.Therapeutic advances in infectious diseaseArticle
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Authors and funding
5 authors.
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Abstract
backgroundIn 2012, the World Health Organization recommended screening and investigation of contacts of index tuberculosis patients as a strategy to accelerate detection of tuberculosis (TB) cases. Nine years after the adoption of this recommendation, coverage of TB contact investigations in Uganda remains low. The objective of this study was to examine health care providers' perceptions of factors influencing coverage of TB contact investigations in three selected rural health facilities in Mbarara district, southwestern Uganda.
methodsThis study identified provider opinions on the barriers and facilitators to implementation of TB contact investigation using the Consolidated Framework for Implementation Research. Using an exploratory qualitative study design, semi-structured interviews with 19 health workers involved in the TB program at district, health facility and community levels were conducted from April 2020 and July 2020. Analysis was conducted inductively using reflexive thematic analysis in six iterative steps: familiarizing with the data, creating initial codes, searching for themes, reviewing themes, developing theme definitions, and writing the report.
resultsNineteen health care workers participated in this study which translates to a 100% response rate. These included two district TB and leprosy supervisors, five nurses, five clinical officers, six village health team members and one laboratory technician. The three themes that emerged from the analysis were intervention-related, health system and contextual factors. Health system-related barriers included inadequate or delayed government funding for the TB program, shortage of human resources, insufficient personal protective equipment, and a stock-out of supplies such as Xpert MTB cartridges. Contextual barriers included steep terrain, poverty or low income, and the stigma associated with TB and COVID-19. Facilitators comprised increased knowledge and understanding of the intervention, performance review and on-the-job training of health workers.
conclusionsThis study found that most of the factors affecting TB contact investigations in this rural community were related to health system constraints such as inadequate or delayed funding and human resource shortages. This can be addressed by strengthening the foundational elements of the health system - health financing and human resources - to establish a comprehensive TB control program that will enable the efficient identification of missing TB patients.
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