Exploring the promise and reality of ward-based primary healthcare outreach teams conducting TB household contact tracing in three districts of South Africa.
Exploring the promise and reality of ward-based primary healthcare outreach teams conducting TB household contact tracing in three districts of South Africa.
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DOI：
10.1371/journal.pone.0256033
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Grant AD
中科院分区：
文献类型：
--
作者：
Chetty-Makkan CM;deSanto D;Lessells R;Charalambous S;Velen K;Makgopa S;Gumede D;Fielding K;Grant AD
结核病家庭接触者追踪是一种有针对性的主动病例发现形式，南非的社区卫生工作者（“外展小组”）主要负责实施。我们进行了一项探索性定性研究，以了解外展小组在提供结核病家庭接触者追踪方面的作用。该研究于2016年5月至2017年2月在南非的三个地区进行。我们进行了78次深入访谈（IDI）（包括35名关键利益相关者，31名结核病指数患者和12名HHC）和5次焦点小组讨论（FGD）（4个FGD中的40名外展团队成员和1个FGD中的12名社区利益相关者）。外展小组作出了积极贡献，在与卫生有关的方案中开展工作，提供家庭护理，并协助追踪因结核病治疗而死亡的人员。然而，外展小组对结核病家庭接触者追踪活动的关注有限，这可能是由于其工作范围广泛，方案支持不足。外展小组经常将结核病家庭接触者追踪活动与寻找因结核病护理而失踪的人员混为一谈。此外，社会人士对外展队伍进行结核病家居接触者追踪活动的角色亦有所保留。需要提高外展工作者和诊所工作人员对结核病家庭接触者追踪的重要性和相关活动的认识，以加强通过社区初级卫生保健小组提供结核病家庭接触者追踪。我们需要更好的监测和评估系统，在现实的工作范围内加强一体化，在结核病家庭接触者追踪和结核病感染预防控制措施方面进行充分的培训。让社区参与并教育他们了解外联小组的作用，可以提高对未来活动的接受程度。这些及时的结果和吸取的经验教训应该为COVID-19背景下的接触者追踪方法提供信息。
Tuberculosis (TB) household contact tracing is a form of targeted active case-finding for which community health workers (‘outreach teams’) in South Africa are primarily responsible for its implementation. We conducted an exploratory qualitative study to understand the role of outreach teams in delivering TB household contact tracing. The study took place in three districts of South Africa between May 2016 and February 2017. We conducted 78 in-depth interviews (IDI) (comprising 35 key stakeholders, 31 TB index patients and 12 HHCs) and five focus group discussions (FGD) (40 outreach team members in four FGDs and 12 community stakeholders in one FGD). Outreach teams contributed positively by working across health-related programmes, providing home-based care and assisting with tracing of persons lost to TB care. However, outreach teams had a limited focus on TB household contact tracing activities, likely due to the broad scope of their work and insufficient programmatic support. Outreach teams often confused TB household contact tracing activities with finding persons lost to TB care. The community also had some reservations on the role of outreach teams conducting TB household contact tracing activities. Creating awareness among outreach workers and clinic personnel about the importance of and activities related to TB household contact tracing would be required to strengthen the delivery of TB household contact tracing through the community-based primary health care teams. We need better monitoring and evaluation systems, stronger integration within a realistic scope of work, adequate training on TB household contact tracing and TB infection prevention control measures. Involving the community and educating them on the role of outreach teams could improve acceptance of future activities. These timely results and lessons learned should inform contact tracing approaches in the context of COVID-19.
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影响因子：
4.8
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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DOI：
10.4102/phcfm.v10i1.1748
发表时间：
2018-01-01
影响因子：
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作者：
Bennett, Rod;Marcus, Tessa S.;Hugo, Jannie F.
通讯作者：
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DOI：
10.4102/phcfm.v9i1.1252
发表时间：
2017-01-01
影响因子：
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作者：
Marcus, Tessa S.;Hugo, Jannie;Jinabhai, Champak C.
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