Evidence map›Paper›PMID 42305737›Full record

ArticleIJTLD open2026

Real-world decision-making for post-exposure management of drug-resistant TB.

C D October, B Beko, A Reuter, V Rennie, N Ismail, E C Conceicao, S Tonsing, R M Warren, S T Malherbe, A Van Rie and 1 more

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In one paragraph

Article in IJTLD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

C D OctoberDivision of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
B BekoDivision of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
A ReuterDivision of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
V RennieFamily Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
N IsmailDSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
E C ConceicaoDSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
S TonsingDivision of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
R M WarrenDivision of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
S T MalherbeDivision of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
A Van RieFamily Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
L ViljoenDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffective post-exposure management is essential to control drug-resistant TB (DR-TB). However, little is known about how health care workers (HCWs) make decisions on post-exposure management in resource-constrained settings.

methodsWe conducted a qualitative study using semi-structured interviews with 22 HCWs in the Western Cape, South Africa. Data were analysed thematically and interpreted using the Situated Clinical Decision-Making Framework (SCDMF) to explore how contextual conditions, knowledge, and clinical cues influence judgement and action in practice.

resultsFour interrelated themes were identified: crowded living conditions in informal settlements; stigma and non-disclosure of TB status; incomplete or delayed clinical information; and limited formal training on DR-TB post-exposure management. These factors constrained HCWs' access to reliable social and clinical cues, limited their ability to assess exposure risk, and made consistent application of guidelines challenging. In response, HCWs relied on experiential knowledge, clinical intuition, and peer consultation to manage uncertainty. Real-world conditions frequently diverged from the SCDMF's assumptions of enabling contexts, timely information, and accessible professional knowledge.

conclusionHCWs' decision-making for DR-TB post-exposure management is shaped by systemic constraints that necessitate adaptive but informal practices. Strengthening diagnostic turnaround times, formal training, and context-sensitive strategies to address stigma is critical to support consistent, evidence-based post-exposure DR-TB care.

Indexed as

health care workerqualitative researchSituated Clinical Decision-Making FrameworkSouth AfricaTB preventive therapytuberculosis

Identifiers

PMID42305737
PMCPMC13268095

What OpenQuestion holds

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LicenceCC BY
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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.