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Open Access Health care workers' fears associated with working in multidrug- and or extensively-resistant tuberculosis wards in South Africa

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SETTING: Twenty-four drug-resistant tuberculosis (TB) hospitals and wards across all nine provinces of South Africa.

OBJECTIVE: To assess health care workers' (HCWs') fears of working in multidrug-resistant TB (MDR-TB) or extensively drug-resistant TB (XDR-TB) wards.

DESIGN: A cross-sectional descriptive study was conducted from June to September 2009 in 24 drug-resistant TB hospitals across South Africa. HCWs completed a self-administered questionnaire, including one open-ended question regarding personal concerns about their fear of contracting MDR- or XDR-TB. Responses were analysed by content analysis.

RESULTS: Among the 24 hospitals, 499 HCWs were surveyed, of whom 363 (73%) responded to the open-ended question: 286 (86%) were nurses, 38 (11%) medical officers and 10 (3%) others. Six major themes regarding fears associated with the personal risk of acquiring drug-resistant TB emerged. These included the fear of 1) developing MDR- and XDR-TB, 2) the treatment course, 3) the financial implications, 4) family concerns, 5) working environment and 6) psychosocial issues.

CONCLUSIONS: These data suggest that the greatest fear of HCWs working in drug-resistant TB wards is contracting MDR- or XDR-TB and infecting others. This fear may negatively impact the provision of quality patient-centred care, and highlights the need for training of HCWs in infection control measures, and specifically on how HCWs can protect themselves and others from developing TB.

Keywords: MDR-TB; XDR-TB; health care worker; tuberculosis

Document Type: Research Article


Affiliations: 1: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA 2: South African Medical Research Council TB Epidemiology and Intervention Research Unit, Pretoria, South Africa 3: Johns Hopkins University School of Nursing, Baltimore, Maryland, USA

Publication date: 2013-10-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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