Knowledge about tuberculosis transmission and prevention and perceptions of health service utilization among index cases and contacts in Brazil: Understanding losses in the latent tuberculosis cascade of care
Knowledge about tuberculosis transmission and prevention and perceptions of health service utilization among index cases and contacts in Brazil: Understanding losses in the latent tuberculosis cascade of care
Data
2017
Autores
Salame, Flavia Matos
Ferreira, Márcia Danielle
Belo, Marcia Teresa
Teixeira, Eleny Guimarães
Cordeiro-Santos, Marcelo
Ximenes, Ricardo Arraes
Albuquerque, Maria de Fa ́tima Militão de
Hill, Philip C.
Menzies, Dick
Trajman, Anete
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Resumo
Introduction
Tuberculosis contacts are candidates for active and latent tuberculosis infection screening
and eventual treatment. However, many losses occur in the different steps of the contacts’
cascade of care. Reasons for this are poorly understood.
Objective
To describe the different steps where losses in the contact cascade occur and to explore
knowledge and attitudes regarding tuberculosis transmission/prevention and perceptions
about tuberculosis services in order to understand the reasons for losses from the tuberculosis service users’ perspective.
Design
We collected routine data from the index case and contact registry books and from patients’
records to build the cascade of care of contacts in 12 health facilities in three Brazilian cities
with high tuberculosis incidence rates. During a knowledge, attitudes and practices (KAP)
survey, trained interviewers administered a semi-structured questionnaire to 138 index
cases and 98 contacts.
Results
Most of the losses in the cascade occurred in the first two steps (contact identification,
43% and tuberculin skin testing placement, 91% of the identified contacts). Among KAP-interviewed contacts, 67% knew how tuberculosis is transmitted, 87% knew its key symp-
toms and 81% declared they would take preventive therapy if prescribed. Among KAP-inter-
viewed index cases, 67% knew they could spread tuberculosis, 70% feared for the health of
their families and 88% would like their family to be evaluated in the same services.
Conclusion
Only a small proportion of contacts are evaluated for active and latent tuberculosis, despite
their—and their index cases’—reasonable knowledge, positive attitudes towards prevention
and satisfaction with tuberculosis services. In these services, education of service users
would not be a sufficient solution. Healthcare workers’ and managers’ perspective, not
explored in this study, may bring more light to this subject.
Description
Palavras-chave
Adult, Brazil, Female, Health Knowledge, Attitudes, Practice*, Health Services / statistics & numerical data*, Humans, Latent Tuberculosis / diagnosis, Latent Tuberculosis / prevention & control*, Latent Tuberculosis / transmission*, Male, Middle Aged, Patient Care / statistics & numerical data*, Surveys and Questionnaires, Urban Population / statistics & numerical data.
Citação
Salame FM, Ferreira MD, Belo MT, Teixeira EG, Cordeiro-Santos M, Ximenes RA, de Albuquerque MFM, Hill PC, Menzies D, Trajman A. Knowledge about tuberculosis transmission and prevention and perceptions of health service utilization among index cases and contacts in Brazil: Understanding losses in the latent tuberculosis cascade of care. PLoS One. 2017 Sep 21;12(9):e0184061. doi: 10.1371/journal.pone.0184061.