Effectiveness of healthcare workers and volunteers training on improving tuberculosis case detection: A systematic review and meta-analysis

Amare, Desalegne; Ambaw, Fentie; Mengesha, Endalkachew Worku; Dessie, Getenet; Shiferaw, Melashu Balew; Dires, Tegenaw Asemamaw; Alene, Kefyalew Addis

doi:10.1371/journal.pone.0271825

Cited by 9 publications

(6 citation statements)

References 30 publications

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“…The meta-analysis by Amare et al . of nine intervention trials demonstrated that training interventions improve the ability of providers to diagnose TB, significantly increasing the number of bacteriologically confirmed cases [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

Uncertainty in tuberculosis clinical decision-making: An umbrella review with systematic methods and thematic analysis

Basile,

Sweeney,

Singh

et al. 2024

PLOS Glob Public Health

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Tuberculosis is a major infectious disease worldwide, but currently available diagnostics have suboptimal accuracy, particularly in patients unable to expectorate, and are often unavailable at the point-of-care in resource-limited settings. Test/treatment decision are, therefore, often made on clinical grounds. We hypothesized that contextual factors beyond disease probability may influence clinical decisions about when to test and when to treat for tuberculosis. This umbrella review aimed to identify such factors, and to develop a framework for uncertainty in tuberculosis clinical decision-making. Systematic reviews were searched in seven databases (MEDLINE, CINAHL Complete, Embase, Scopus, Cochrane, PROSPERO, Epistemonikos) using predetermined search criteria. Findings were classified as barriers and facilitators for testing or treatment decisions, and thematically analysed based on a multi-level model of uncertainty in health care. We included 27 reviews. Study designs and primary aims were heterogeneous, with seven meta-analyses and three qualitative evidence syntheses. Facilitators for decisions to test included providers’ advanced professional qualification and confidence in tests results, availability of automated diagnostics with quick turnaround times. Common barriers for requesting a diagnostic test included: poor provider tuberculosis knowledge, fear of acquiring tuberculosis through respiratory sampling, scarcity of healthcare resources, and complexity of specimen collection. Facilitators for empiric treatment included patients’ young age, severe sickness, and test inaccessibility. Main barriers to treatment included communication obstacles, providers’ high confidence in negative test results (irrespective of negative predictive value). Multiple sources of uncertainty were identified at the patient, provider, diagnostic test, and healthcare system levels. Complex determinants of uncertainty influenced decision-making. This could result in delayed or missed diagnosis and treatment opportunities. It is important to understand the variability associated with patient-provider clinical encounters and healthcare settings, clinicians’ attitudes, and experiences, as well as diagnostic test characteristics, to improve clinical practices, and allow an impactful introduction of novel diagnostics.

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Section: Resultsmentioning

confidence: 99%

Uncertainty in tuberculosis clinical decision-making: An umbrella review with systematic methods and thematic analysis

Basile,

Sweeney,

Singh

et al. 2024

PLOS Glob Public Health

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“… 24 Therefore, continuous training and support of local staff are necessary to increase tuberculosis diagnosis and encourage the initiation of preventive treatment in high-risk groups. 25 …”

Section: Discussionmentioning

confidence: 99%

Tuberculosis contact tracing, Angola

Martínez-Campreciós,

Gil,

Aixut

et al. 2024

Bull World Health Organ

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Objective To assess the outcomes of a contact-tracing programme to increase the diagnosis of tuberculosis in Cubal, Angola and offer preventive treatment to high-risk groups. Methods A health centre-based contact-tracing programme was launched in Hospital Nossa Senhora da Paz in March 2015 and we followed the programme until 2022. In that time, staffing and testing varied which we categorized as four periods: medical staff reinforcement, 2015–2017, with a doctor seconded from Vall d’Hebron University Hospital, Spain; routine staff, 2017–2021, with no external medical support; community directly observed treatment (DOT), 2018–2019 with community worker support; and enhanced contact tracing, 2021–2022, with funding that allowed free chest radiographs, molecular and gastric aspirate testing. We assessed differences in contacts seen each month, and testing and treatment offered across the four periods. Findings Overall, the programme evaluated 1978 contacts from 969 index cases. Participation in the programme was low, although it increased significantly during the community DOT period. Only 16.6% (329/1978) of contacts had a chest radiograph. Microbiological confirmation increased to 72.2% (26/36) after including molecular testing, and 10.1% (200/1978) of contacts received treatment for tuberculosis. Of 457 contacts younger than 5 years, 36 (7.9%) received preventive tuberculosis treatment. Half of the contacts were lost to follow-up before a final decision was taken on treatment. Conclusion Contact tracing increased the diagnosis of tuberculosis although engagement with the programme was low and loss to follow-up was high. Participation increased during community DOT. Community-based screening should be explored to improve participation and diagnosis.

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“…The international literature reinforces the importance of better training professionals to properly detect and treat TB, revealing that using technologies in training activities can facilitate professional learning (24)(25)(26)(27)(28) . This has a relevant impact on health care quality, optimizing costs and time investment, in addition to contributing to expanding case detection and achieving the global goals of the End TB Strategy (29) .…”

Section: Introductionmentioning

confidence: 98%

Educational technology on tuberculosis: construction shared with Primary Health Care nurses

Soares,

Nogueira,

Andrade

et al. 2023

Rev. Bras. Enferm.

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Objective: to develop, in a participatory way, an educational technology to assist nurses in the management of tuberculosis cases in Primary Health Care. Methods: methodological research with a qualitative approach. Data were collected between June and October 2022, in 25 Basic Health Units, with 41 nurses interviewed individually. Thematic content analysis was carried out to guide technology elaboration. Results: three empirical categories were organized, demonstrating the facilities and difficulties in tuberculosis management, the conceptions about educational technology as a facilitator of the teaching-learning process in Primary Health Care and participatory development of technology. Nurses were in favor of constructing an instructional guide technology, and made suggestions to encourage its creation and use in daily service routine. Final considerations: the participatory process made it possible to create technology to assist nurses in the teaching-learning process in Primary Health Care about caring for people with tuberculosis.

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Effectiveness of healthcare workers and volunteers training on improving tuberculosis case detection: A systematic review and meta-analysis

Cited by 9 publications

References 30 publications

Uncertainty in tuberculosis clinical decision-making: An umbrella review with systematic methods and thematic analysis

Uncertainty in tuberculosis clinical decision-making: An umbrella review with systematic methods and thematic analysis

Tuberculosis contact tracing, Angola

Educational technology on tuberculosis: construction shared with Primary Health Care nurses

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