A qualitative study to inform the development of a decision support tool for the diagnosis of pulmonary tuberculosis in Tigray, Ethiopia.

Ingentiumby Ingentium

In Tuberculosis Literature.

Publication date: Nov 14, 2024

Tuberculosis (TB) is Ethiopia’s leading infectious killer disease. The war in the Tigray region of Ethiopia has resulted in the disruption of TB care services. Prediction models are recommended to aid the diagnosis of TB in resource-limited settings. However, the development of such decision-support tools without the participation of end users may not be successful. To inform the tool development, we described barriers to diagnosing TB and identified applicable and desirable parameters for the proposed tool. We conducted a qualitative study between February and June 2023 in two cities in Tigray, Northern Ethiopia. We conducted 12 in-depth interviews and four focus group discussions with healthcare workers (HCWs). Interviews were translated, coded, and analyzed to identify predefined and emergent themes during the thematic analysis. Healthcare workers used symptoms, risk factors, signs, and investigations to diagnose TB. However, failure to ask about antibiotic use, the absence and non-affordability of investigations, and patient load were barriers affecting the diagnosis of TB. Most of the classic TB symptoms and their duration were sorted as very important, simple, reliable, generalizable, and desirable indices. In addition, a trial of antibiotics, being chronically sick-looking, having HIV, having a contact history with a TB patient, and an erythrocyte sedimentation rate fulfilled the above criteria. In the TB diagnostic process, HCWs account for a variety of data, but they prefer the classic symptoms of TB to heighten their clinical suspicion. Antibiotic trials and some risk factors were also considered reasonable. However, when HCWs have a heavy workload and a shortage of investigations, they experience a suboptimal TB diagnostic process. Hence, appropriate context consideration and care providers’ preferences for parameters will inform tool development.

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Concepts Keywords
Ethiopia Diagnosis
February Ethiopia
Interviews Presentation
June Tigray
Tuberculosis Tuberculosis
War

Semantics

Type Source Name
disease MESH pulmonary tuberculosis
disease MESH Tuberculosis
pathway KEGG Tuberculosis
disease IDO history
disease IDO process
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
disease MESH death
disease MESH malaria
pathway KEGG Malaria
disease IDO country
drug DRUGBANK Trestolone
disease MESH tic
drug DRUGBANK Methionine
disease MESH weight loss
disease MESH pneumonia
drug DRUGBANK Medical air
drug DRUGBANK Nonoxynol-9
disease MESH sweating
disease MESH chest pain
disease IDO blood
disease MESH inflammation
disease IDO facility
disease MESH fibrosis
disease MESH lymphadenopathy
disease MESH scar
disease MESH Malnutrition
disease MESH lung cancer
disease MESH diabetes mellitus
disease MESH chronic illnesses
drug DRUGBANK Ethanol
disease MESH silicosis
disease MESH lung disease
disease MESH opportunistic infections
disease IDO reagent
disease MESH Pleural effusion
disease MESH misdiagnosis
disease MESH insomnia
drug DRUGBANK Tretamine
disease MESH anorexia
disease MESH HIV infection
pathway REACTOME HIV Infection
disease MESH Congestive heart failure
disease MESH cancer
disease MESH pulmonary embolism
drug DRUGBANK Etoperidone
pathway REACTOME Immune System
disease IDO intervention
disease MESH infectious disease
pathway REACTOME Infectious disease
drug DRUGBANK Ademetionine
drug DRUGBANK Ciclosporin
drug DRUGBANK Riboprine
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH infection
disease MESH AIDS
disease MESH abnormalities
disease IDO immunodeficiency
disease MESH Leprosy
disease MESH complications

Original Article

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