Exploring local realities: Perceptions and experiences of healthcare workers on the management and control of drug-resistant tuberculosis in Addis Ababa, Ethiopia

• Published in: PloS one Vol. 14; no. 11; p. e0224277
• Main Authors: Mussie, Kirubel Manyazewal, Yimer, Solomon Abebe, Manyazewal, Tsegahun, Gradmann, Christoph
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.11.2019; PLOS; Public Library of Science (PLoS)
• Subjects: Analysis; Antitubercular agents; Antitubercular Agents - therapeutic use; Attitude of Health Personnel; Critical thinking; Delivery of Health Care; Developing Countries; Direct reduction; Drug resistance; Drug therapy; Dystopias; Epidemiology; Ethiopia; Grass roots movement; Health aspects; Health care; Health care facilities; Health care industry; Health facilities; Health Personnel; Health risks; Hospitals; Humans; Interviews as Topic; LDCs; Medical personnel; Medical research; Medicine and Health Sciences; Microbial drug resistance; Multidrug resistant organisms; Nurses; Nutrition; People and Places; Perceptions; Poverty; Public awareness; Public health; Public health movements; Qualitative analysis; Qualitative Research; Security; Social factors; Social Sciences; Technicians; Tuberculosis; Tuberculosis, Multidrug-Resistant - drug therapy; Workers; Ethiopia; Norway; Africa; Russia; Addis Ababa Ethiopia; India
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0224277

Drug-resistant tuberculosis (DR-TB) remains a major health security threat worldwide. The effectiveness of implementation of DR-TB control strategies has been a subject of research and controversy. In resource-limited settings, using conventional medicine as the only framework to explain DR-TB gives a rather incomplete picture of the disease. This study intended to explore the perceptions and experiences of healthcare workers on the management and control of DR-TB in Addis Ababa, Ethiopia. The study employed a qualitative methodology with an inductive approach and a thematic analysis. It involved in-depth interviews with healthcare workers providing clinical services to DR-TB patients in 10 public healthcare facilities in Addis Ababa, Ethiopia. A total of 18 healthcare workers participated until data saturation, which included 12 clinical nurses, four health officers and two medical laboratory technicians. The findings show that healthcare workers perceive DR-TB as a growing public health threat in Ethiopia, due to factors such as poverty, poor nutrition, crowded settings, healthcare worker and general public awareness of DR-TB, lack of good governance and culture. The perspectives drawn from the healthcare workers shed more light on the image of DR-TB in a developing country context. It has been shown that understanding DR-TB is not confined to what can be drawn from the sphere of biomedicine. There are also interconnected barriers, which predict a dystopia in the epidemiology of DR-TB. Bringing DR-TB under control requires taking a step back from an overwhelming focus on the biomedical facets of the disease, and employ critical thinking on the wider social and structural forces as equally important targets.