Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.

<h4>Introduction</h4>Optimal tuberculosis contact investigation impacts TB prevention, timely case finding and linkage to care, however data on routine implementation in high burden contexts is limited.<h4>Materials and methods</h4>In a multi-method qualitative study based on...

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Main Authors: Diana Marangu, Hannah Mwaniki, Salome Nduku, Elizabeth Maleche-Obimbo, Walter Jaoko, Joseph Babigumira, Grace John-Stewart, Deepa Rao
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183749&type=printable
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author Diana Marangu
Hannah Mwaniki
Salome Nduku
Elizabeth Maleche-Obimbo
Walter Jaoko
Joseph Babigumira
Grace John-Stewart
Deepa Rao
author_facet Diana Marangu
Hannah Mwaniki
Salome Nduku
Elizabeth Maleche-Obimbo
Walter Jaoko
Joseph Babigumira
Grace John-Stewart
Deepa Rao
author_sort Diana Marangu
collection DOAJ
description <h4>Introduction</h4>Optimal tuberculosis contact investigation impacts TB prevention, timely case finding and linkage to care, however data on routine implementation in high burden contexts is limited.<h4>Materials and methods</h4>In a multi-method qualitative study based on individual interviews with TB patients, facility observations and focus group discussions with health workers (HWs) in 13 public health facilities, and key informant interviews with governmental and non-governmental experts, we describe TB contact investigation in the context of an urban setting in Kenya and identify opportunities for optimization.<h4>Results</h4>Invitation of TB patients to bring close contacts by HWs was key for all patient decisions that led to contact screening in addition to patients' understanding of TB transmission and desire to avoid contacts suffering from TB. Sub-optimal HW enquiry of TB patients and contacts presenting at the facility were missed opportunities which stemmed from lack of standardized operational procedures, documentation tools and HW training. Stakeholders proposed provision of fast tracked and holistic health packages for contacts seeking TB screening, and sustainable government led funding for the requisite infrastructure and workforce.<h4>Conclusion</h4>TB contact invitation by HWs leading to contact screening occurs in this context. Stakeholder perspectives inform the design of an operational framework for optimized delivery.
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spelling doaj-art-b71a9a39ba3f4a089a9d22d167f7325a2025-08-20T02:45:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01129e018374910.1371/journal.pone.0183749Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.Diana MaranguHannah MwanikiSalome NdukuElizabeth Maleche-ObimboWalter JaokoJoseph BabigumiraGrace John-StewartDeepa Rao<h4>Introduction</h4>Optimal tuberculosis contact investigation impacts TB prevention, timely case finding and linkage to care, however data on routine implementation in high burden contexts is limited.<h4>Materials and methods</h4>In a multi-method qualitative study based on individual interviews with TB patients, facility observations and focus group discussions with health workers (HWs) in 13 public health facilities, and key informant interviews with governmental and non-governmental experts, we describe TB contact investigation in the context of an urban setting in Kenya and identify opportunities for optimization.<h4>Results</h4>Invitation of TB patients to bring close contacts by HWs was key for all patient decisions that led to contact screening in addition to patients' understanding of TB transmission and desire to avoid contacts suffering from TB. Sub-optimal HW enquiry of TB patients and contacts presenting at the facility were missed opportunities which stemmed from lack of standardized operational procedures, documentation tools and HW training. Stakeholders proposed provision of fast tracked and holistic health packages for contacts seeking TB screening, and sustainable government led funding for the requisite infrastructure and workforce.<h4>Conclusion</h4>TB contact invitation by HWs leading to contact screening occurs in this context. Stakeholder perspectives inform the design of an operational framework for optimized delivery.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183749&type=printable
spellingShingle Diana Marangu
Hannah Mwaniki
Salome Nduku
Elizabeth Maleche-Obimbo
Walter Jaoko
Joseph Babigumira
Grace John-Stewart
Deepa Rao
Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.
PLoS ONE
title Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.
title_full Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.
title_fullStr Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.
title_full_unstemmed Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.
title_short Stakeholder perspectives for optimization of tuberculosis contact investigation in a high-burden setting.
title_sort stakeholder perspectives for optimization of tuberculosis contact investigation in a high burden setting
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183749&type=printable
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