Capacity Building, Knowledge Enhancement, and Consultative Processes for Development of a Digital Tool (Ni-kshay SETU) to Support the Management of Patients with Tuberculosis: Exploratory Qualitative Study

Cross-sectional study of preventive treatment for students with latent tuberculosis infection in Shanghai, China

INTRODUCTION

Tuberculosis preventive treatment (TPT) has been initiated systematically in Shanghai supported by a public health project. This study aimed to evaluate the acceptance of TPT, identify the factors related to its refusal, and find an optimal way to promote TPT among student tuberculosis (TB) contacts.

METHODS

We screened contacts of the TB index case from a TB outbreak on campus. A two-step approach of first conducting a lecture of TB health literacy, followed by one-on-one TPT consultations was used to mobilise TPT among students with latent TB infection (LTBI). A semistructured questionnaire was designed between the lecture and the one-on-one TPT consultations, covering general demographic information, awareness of core TB knowledge and willingness to accept TPT, along with the reasons for refusal. Logistic regression analysis was used to identify the risk factors for refusing TPT.

RESULTS

A total of 52 contacts were identified with LTBI. After the lecture on TB health literacy, their scores on the core TB knowledge was 14.0±2.3. Students had a poor awareness rate of TB knowledge in the part of TB treatment and policy (70.2%) and Mycobacterium tuberculosis infection preventive measures and LTBI (67.3%) compared with the average rate (84.3%). The acceptance rate of TPT reached 42.3% at the end of the two-step promotion. The main reasons for refusing TPT included: (1) the duration for TPT was too long and follow-up management was too cumbersome; (2) the confidence in their own immunity and belief in their low risk of TB and (3) the fear of side effects of TPT.

CONCLUSIONS

The two-step approach of first conducting a lecture of TB health literacy, followed by one-on-one TPT consultations, is effective for mobilising TPT. To further implement TPT, we recommend making the scientific popularisation for LTBI in a more easy-to-understand way and optimising the management of TPT.

Bridging the Gap: A Strategic Approach to Upscale Knowledge Among Diverse Healthcare Providers for Effective Tuberculosis Management in Gujarat, India

INTRODUCTION

Tuberculosis (TB) remains a global health challenge, particularly in low- and middle-income countries. Knowledge gaps among healthcare providers (HCPs) significantly impact TB management, hindering timely care-seeking and effective interventions.

OBJECTIVE

The primary objective was to assess knowledge gaps among 3086 HCPs engaged in the National Tuberculosis Elimination Program (NTEP) implementation in Gujarat, India. The study provided a platform to develop and implement cadre-specific training modules to address identified knowledge deficiencies and enhance TB management.

METHODOLOGY

The study was conducted in two phases. Phase one was designed as a cross-sectional assessment to identify the knowledge gaps. Phase two involved the development of cadre-specific training modules based on identified deficiencies in the knowledge, crafted with collaboration from an expert panel. The training impact will be evaluated after completion of the training of all cadres through a comprehensive assessment.

RESULTS

Out of 3086 assessed HCPs, 26% scored below the passing benchmark, revealing significant knowledge gaps. The variations were observed among and within the same cadres, with the accredited social health activists (ASHAs) and community health workers showing higher proficiency while pharmacists and medical officers showed lower proficiency. The cadre-specific training modules and training cascade were designed to address these gaps and improve TB-related knowledge and skills.

CONCLUSION

The study underscores the critical need for targeted interventions to address knowledge gaps among HCPs involved in TB control. The customized HCP-specific training programs are recommended to enhance knowledge, improve TB management, and contribute to national TB elimination goals.