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Patient satisfaction with directly observed treatment and multidrug-resistant tuberculosis injection administration by lay health workers in rural Eswatini.


ABSTRACT: BACKGROUND:The human resources for health crisis in rural Eswatini led to a novel community-based multidrug-resistant tuberculosis (MDR-TB) treatment strategy based on task-shifting, that is delegation of directly observed treatment (DOT) and administration of MDR-TB injections, traditionally restricted to professional nurses, to lay community treatment supporters (CTSs). AIM:This study assessed the level of patient satisfaction with receiving community-based MDR-TB care from a CTS. SETTING:The study was conducted at three MDR-TB-treating facilities in the mostly rural Shiselweni region. METHODS:A cross-sectional survey of a purposive sample of 78 patients receiving DOT and intramuscular MDR-TB injections from CTSs was carried out in 2017. Descriptive statistics and regressions were calculated. RESULTS:A high overall general patient satisfaction score for receiving community-based MDR-TB care from a CTS was observed. Adherence counselling, confidentiality, provider selection and treatment costs significantly (p 0.05) influenced satisfaction. A large majority (n = 62; 79.5%) of patients indicated that they would likely recommend their significant others to receive MDR-TB care from a CTS. Respondents identified the need to provide CTSs with adequate training, regular supervision and sufficient incentives and also to broaden the scope of their services. CONCLUSION:This study observed that task-shifting of DOT and MDR-TB injection administration to CTSs was supported from a patient perspective. However, adherence counselling, confidentiality, provider selection and treatment costs should be taken into account in community-based MDR-TB care programming. Further to the patients, community-based tuberculosis care could be enhanced by improving CTSs' training, supervision and incentives, and broadening the scope of their services.

SUBMITTER: Peresu E 

PROVIDER: S-EPMC7284164 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Patient satisfaction with directly observed treatment and multidrug-resistant tuberculosis injection administration by lay health workers in rural Eswatini.

Peresu Ernest E   Heunis Christo J CJ   Kigozi Gladys N GN   De Grave Diana D  

African journal of primary health care & family medicine 20200526 1


<h4>Background</h4>The human resources for health crisis in rural Eswatini led to a novel community-based multidrug-resistant tuberculosis (MDR-TB) treatment strategy based on task-shifting, that is delegation of directly observed treatment (DOT) and administration of MDR-TB injections, traditionally restricted to professional nurses, to lay community treatment supporters (CTSs).<h4>Aim</h4>This study assessed the level of patient satisfaction with receiving community-based MDR-TB care from a CT  ...[more]

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