Knowledge, attitudes and practices on tuberculosis transmission and prevention among auxiliary healthcare professionals in three Brazilian high-burden cities: a cross- sectional survey
Knowledge, attitudes and practices on tuberculosis transmission and prevention among auxiliary healthcare professionals in three Brazilian high-burden cities: a cross- sectional survey
Data
2019
Autores
Trajman, Anete
Wakoff-Pereira, Maria F.
Ramos-Silva, Jonas
Cordeiro-Santos, Marcelo
Albuquerque, Maria de Fátima Militão de
Hill, Philip C.
Menzies, Dick
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Health Services Research
Resumo
Background: Tuberculosis elimination requires treatment of latently infected high-risk persons, such as contacts of
index cases. Identification and referral of tuberculosis contacts for investigation are major barriers in the contact
cascade-of-care. These tasks rely heavily on auxiliary primary healthcare workers in many low- and middle-income
countries. We aimed to understand their knowledge, attitudes and practices (KAP) regarding contact investigation
in Brazil.
Methods: We conducted a cross-sectional KAP survey on tuberculosis transmission and prevention among 135
auxiliary healthcare workers in three tuberculosis high-burden Brazilian cities. Trained interviewers applied a
translated version of a previously applied questionnaire. Open answers were classified in pre-defined objective
categories and analysed quantitatively. Answers were further classified as satisfactory or not according to criteria set
by a panel of three specialists.
Results: Although 66% had received tuberculosis training in the past 10 years, only 19% were trained for
tuberculosis prevention. 64% could not clearly distinguish latent tuberculosis infection (LTBI) from active
tuberculosis; 63% did not know how to diagnose LTBI and 52% did not know how to prevent progression to active
tuberculosis. Most believed that it is important to investigate adult (99%) and child (96%) contacts for LTBI.
However, not all invite contacts - children (81%) or adults (71%) - to the clinic, despite only 24% perceiving
difficulties for investigation.
Conclusions: Gaps in KAP among auxiliary health workers have been reported in other areas, such as obstetrics
and other infectious diseases. To the best of our knowledge, this is the first KAP survey on tuberculosis transmission
and prevention among auxiliary health care workers, and relevant gaps were also found. Knowledge gaps were
notably related to LTBI management, including how to recognize it and prevent progression to active tuberculosis
through treatment, despite most recognizing the importance of investigating contacts. Auxiliary healthcare workers
in three Brazilian high-burden cities have important knowledge gaps despite their perception of the importance of
tuberculosis prevention among contacts. They need to incorporate contact referral as one of their tasks to enable
progress toward the target of tuberculosis elimination.
Description
Palavras-chave
Primary health care, Latent tuberculosis infection, Auxiliary healthcare worker, Health knowledge attitudes, practice survey.
Citação
Trajman A, Wakoff-Pereira MF, Ramos-Silva J, Cordeiro-Santos M, Militão de Albuquerque MF, Hill PC, Menzies D. Knowledge, attitudes and practices on tuberculosis transmission and prevention among auxiliary healthcare professionals in three Brazilian high-burden cities: a cross-sectional survey. BMC Health Serv Res. 2019 Jul 30;19(1):532. doi: 10.1186/s12913-019-4231-x.