Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries
Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries
Data
2020
Autores
Alsdurf, H.
Oxlade, O.
Adjobimey, M.
Ahmad Khan, F.
Bastos, M.
Bedingfield, N.
Benedetti, A.
Boafo, D.
Buu, T. N.
Chiang, L.
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Health Services Research
Resumo
Background: The End TB Strategy calls for global scale-up of preventive treatment for latent tuberculosis infection
(LTBI), but little information is available about the associated human resource requirements. Our study aimed to
quantify the healthcare worker (HCW) time needed to perform the tasks associated with each step along the LTBI
cascade of care for household contacts of TB patients.
Methods: We conducted a time and motion (TAM) study between January 2018 and March 2019, in which
consenting HCWs were observed throughout a typical workday. The precise time spent was recorded in pre-
specified categories of work activities for each step along the cascade. A linear mixed model was fit to estimate the
time at each step.
Results: A total of 173 HCWs in Benin, Canada, Ghana, Indonesia, and Vietnam participated. The greatest amount of
time was spent for the medical evaluation (median: 11 min; IQR: 6–16), while the least time was spent on reading a
tuberculin skin test (TST) (median: 4 min; IQR: 2–9). The greatest variability was seen in the time spent for each
medical evaluation, while TST placement and reading showed the least variability. The total time required to
complete all steps along the LTBI cascade, from identification of household contacts (HHC) through to treatment
initiation ranged from 1.8 h per index TB patient in Vietnam to 5.2 h in Ghana.
Conclusions: Our findings suggest that the time requirements are very modest to perform each step in the latent
TB cascade of care, but to achieve full identification and management of all household contacts will require
additional human resources in many settings.
Description
Palavras-chave
Latent tuberculosis infection, Cascade-of-care, Time and motion study.
Citação
Alsdurf H, Oxlade O, Adjobimey M, Ahmad Khan F, Bastos M, Bedingfield N, Benedetti A, Boafo D, Buu TN, Chiang L, Cook V, Fisher D, Fox GJ, Fregonese F, Hadisoemarto P, Johnston JC, Kassa F, Long R, Moayedi Nia S, Nguyen TA, Obeng J, Paulsen C, Romanowski K, Ruslami R, Schwartzman K, Sohn H, Strumpf E, Trajman A, Valiquette C, Yaha L, Menzies D. Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries. BMC Health Serv Res. 2020 Apr 21;20(1):341. doi: 10.1186/s12913-020-05220-7.