Evidence map›Paper›PMID 40504844›Full record

ArticlePLOS global public health2025

Healthcare providers' knowledge, attitudes, and perceptions from using targeted sequencing to diagnose and manage drug-resistant tuberculosis (DR-TB) in Eswatini.

Maia Madison, Debrah Vambe, Sein Sein Thi, Mangaliso Ziyane, Nosisa Shiba, Babongile Blisset Nkala, Tara Ness, Agostinho Viana Lima, Sindisiwe Dlamini, Siphiwe Ngwenya and 2 more

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Maia MadisonBaylor College of Medicine Children's Foundation Eswatini, Mbabane, Eswatini.ORCID https://orcid.org/0000-0001-9410-5150
Debrah VambeBaylor College of Medicine Children's Foundation Eswatini, Mbabane, Eswatini.
Sein Sein ThiNational Tuberculosis Control Program, Manzini, Eswatini.
Mangaliso ZiyaneEswatini, Health Laboratory Services, Mbabane, Eswatini.
Nosisa ShibaBaylor College of Medicine Children's Foundation Eswatini, Mbabane, Eswatini.
Babongile Blisset NkalaBaylor College of Medicine Children's Foundation Eswatini, Mbabane, Eswatini.ORCID https://orcid.org/0009-0004-9857-2038
Tara NessThe Global Tuberculosis Program, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America.
Agostinho Viana LimaCentro de Investigação em Saúde de Manhiça, Manhiça, Mozambique.ORCID https://orcid.org/0000-0002-3866-4385
Sindisiwe DlaminiEswatini, Health Laboratory Services, Mbabane, Eswatini.
Siphiwe NgwenyaNational Tuberculosis Control Program, Manzini, Eswatini.
Anna MandalakasThe Global Tuberculosis Program, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America.ORCID https://orcid.org/0000-0002-8091-3509
Alexander KayBaylor College of Medicine Children's Foundation Eswatini, Mbabane, Eswatini.ORCID https://orcid.org/0000-0001-5283-4697

Funding

Developing Clinical Prediction Tools to Define Strategies for Differentiated Service Delivery in Children and Adolescents Living with HIV in sub-Saharan Africa.K01TW011482 · FIC · BAYLOR COLLEGE OF MEDICINE · PI KAY, ALEXANDER WILLIAM · 2020 to 2024
$749k
FIC NIH HHS K01 TW011482
6 · The paper itself

Abstract

Challenges in diagnosing drug-resistant tuberculosis (DR-TB) contribute to a diagnostic gap. Design-locked Targeted Sequencing (TS) assays have the potential to improve DR-TB diagnosis and management. TS assays are now being introduced into low-income, high TB burden settings. Eswatini is among the first high burden countries to have implemented TS for patient care. To evaluate the impact of the current program and optimize future implementation, we evaluated healthcare provider knowledge, attitudes, and perceptions (KAP) of TS and its implementation. We conducted semi-structured interviews with healthcare providers. Interviews were continued until data saturation was reached and analyzed by directed thematic analysis. The study was conducted at 85% of all DR-TB treatment centers (12/14) in rural and urban settings across all four regions in Eswatini. We interviewed nine doctors and eight nurses who were purposively sampled from DR-TB care sites in Eswatini. We found that providers' experience, roles, and settings informed their knowledge and perceptions of DR-TB diagnosis and management. While all healthcare providers wanted to improve comprehensive drug susceptibility testing, operational challenges with the existing program shaped their KAP of TS. In some instances, providers reported that results from TS on sputum improved their ability to provide quality DR-TB patient care. However, they perceived a need for improvements in the delivery of TS results and desired more training to inform their current use of results from sputum and potential future use of results from stool. Overall, healthcare providers recognized TS as an important new tool with the potential to improve DR-TB patient care. However, they also recognized the need for additional healthcare worker training, community engagement, forecasting to avoid reagent shortages, and enhanced medical information systems. Investments in these areas would likely support more effective and sustainable implementation in Eswatini and other LMICs with high TB burdens.

Identifiers

PMID40504844
PMCPMC12161584

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.