Preferences of healthcare workers using tongue swabs for tuberculosis diagnosis during COVID-19.
Preferences of healthcare workers using tongue swabs for tuberculosis diagnosis during COVID-19.
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DOI：
10.1371/journal.pgph.0001430
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Cangelosi, Gerard A
中科院分区：
文献类型：
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作者：
Codsi, Renee;Errett, Nicole A;Luabeya, Angelique K;Van As, Danelle;Hatherill, Mark;Shapiro, Adrienne E;Lochner, Katherine A;Vingino, Alexandria R;Kohn, Marlana J;Cangelosi, Gerard A
与结核病患者接触的卫生保健工作者（HCWs）感染结核病和患病的风险较高。收集和处理用于结核病诊断的痰样本对卫生保健工作人员构成暴露风险，特别是在气溶胶控制有限的环境中。设计了另一种样本采集方法——舌拭法，以帮助减轻这种风险，目前正在多种情况下进行评估。本研究评估了在2019冠状病毒病大流行期间在结核病诊断研究中使用舌拭法的南非卫生保健员的风险认知。我们描述了他们在特定环境下的偏好，以及在临床和社区环境中使用舌拭子的促进因素和障碍。参与者（n = 18）是在南非结核病疫苗倡议（SATVI）中具有使用实验性舌拭法经验的卫生保健员。我们使用关键信息半结构化访谈来评估对两种舌拭子策略的态度：提供者收集的拭子（PS）和监督的自我拭子（SSS）。通过快速定性分析和专题分析方法对这些访谈的反应进行分析。促进因素包括厌恶痰（PS和SSS），感知方法的安全性（SSS）和培训患者的教育资源（SSS）。障碍包括文化耻辱、个人安全和在社区环境中收集棉签时对工作环境的控制。COVID-19风险认知是PS方法的重大障碍。卫生保健工作者使用舌拭法的动机因使用案例而有很大差异，以及卫生保健工作者是否有权力和机构在特定环境中实施安全预防措施。这些发现表明，需要根据具体情况提供教育资源，以提高SSS收集方法的安全性和依从性。
Healthcare workers (HCWs) who come into contact with tuberculosis (TB) patients are at elevated risk of TB infection and disease. The collection and handling of sputum samples for TB diagnosis poses exposure risks to HCWs, particularly in settings where aerosol containment is limited. An alternative sample collection method, tongue swabbing, was designed to help mitigate this risk, and is under evaluation in multiple settings. This study assessed risk perceptions among South African HCWs who used tongue swabbing in TB diagnostic research during the COVID-19 pandemic. We characterized their context-specific preferences as well as the facilitators and barriers of tongue swab use in clinical and community settings. Participants (n = 18) were HCWs with experience using experimental tongue swabbing methods at the South African Tuberculosis Vaccine Initiative (SATVI). We used key informant semi-structured interviews to assess attitudes toward two tongue swab strategies: Provider-collected swabbing (PS) and supervised self-swabbing (SSS). Responses from these interviews were analyzed by rapid qualitative analysis and thematic analysis methods. Facilitators included aversion to sputum (PS and SSS), perceived safety of the method (SSS), and educational resources to train patients (SSS). Barriers included cultural stigmas, as well as personal security and control of their work environment when collecting swabs in community settings. COVID-19 risk perception was a significant barrier to the PS method. Motivators for HCW use of tongue swabbing differed substantially by use case, and whether the HCW has the authority and agency to implement safety precautions in specific settings. These findings point to a need for contextually specific educational resources to enhance safety of and adherence to the SSS collection method.