Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar
There is no published evidence on contact investigation among multidrug-resistant tuberculosis (MDR-TB) patients from Myanmar. We describe the cascade of contact investigation conducted in 27 townships of Myanmar from January 2018 to June 2019 and its implementation challenges. This was a mixed-meth...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2019-12-01
|
Series: | Tropical Medicine and Infectious Disease |
Subjects: | |
Online Access: | https://www.mdpi.com/2414-6366/5/1/3 |
id |
doaj-6547d7f46c2049e2876d0c1c8dd11867 |
---|---|
record_format |
Article |
spelling |
doaj-6547d7f46c2049e2876d0c1c8dd118672020-11-25T02:36:53ZengMDPI AGTropical Medicine and Infectious Disease2414-63662019-12-0151310.3390/tropicalmed5010003tropicalmed5010003Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from MyanmarAye Mon Phyo0Ajay M. V. Kumar1Kyaw Thu Soe2Khine Wut Yee Kyaw3Aung Si Thu4Pyae Phyo Wai5Sandar Aye6Saw Saw7Htet Myet Win Maung8Si Thu Aung9TB Department, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay 15021, MyanmarCentre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 75006 Paris, FranceDepartment of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Pyin Oo Lwin 05081, MyanmarCentre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 75006 Paris, FranceTB Department, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay 15021, MyanmarTB Department, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay 15021, MyanmarTB Department, International Union Against Tuberculosis and Lung Disease (The Union), Mandalay 15021, MyanmarDepartment of Medical Research, Ministry of Health and Sports, Yangon 11191, MyanmarNational Tuberculosis Programme, Ministry of Health and Sports, Nay Pyi Taw 15011, MyanmarNational Tuberculosis Programme, Ministry of Health and Sports, Nay Pyi Taw 15011, MyanmarThere is no published evidence on contact investigation among multidrug-resistant tuberculosis (MDR-TB) patients from Myanmar. We describe the cascade of contact investigation conducted in 27 townships of Myanmar from January 2018 to June 2019 and its implementation challenges. This was a mixed-methods study involving quantitative (cohort analysis of programme data) and qualitative components (thematic analysis of interviews of 8 contacts and 13 health care providers). There were 556 MDR-TB patients and 1908 contacts, of whom 1134 (59%) reached the health centres for screening (chest radiography and symptoms). Of the latter, 344 (30%) had presumptive TB and of them, 186 (54%) were investigated (sputum microscopy or Xpert MTB/RIF<sup>®</sup>). A total of 27 TB patients were diagnosed (six bacteriologically-confirmed including five with rifampicin resistance). The key reasons for not reaching township TB centres included lack of knowledge and lack of risk perception owing to wrong beliefs among contacts, financial constraints related to loss of wages and transportation charges, and inconvenient clinic hours. The reasons for not being investigated included inability to produce sputum, health care providers being unaware of or not agreeing to the investigation protocol, fixed clinic days and times, and charges for investigation. The National Tuberculosis Programme needs to note these findings and take necessary action.https://www.mdpi.com/2414-6366/5/1/3contactscontact tracingcontact investigationmdr-tb |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Aye Mon Phyo Ajay M. V. Kumar Kyaw Thu Soe Khine Wut Yee Kyaw Aung Si Thu Pyae Phyo Wai Sandar Aye Saw Saw Htet Myet Win Maung Si Thu Aung |
spellingShingle |
Aye Mon Phyo Ajay M. V. Kumar Kyaw Thu Soe Khine Wut Yee Kyaw Aung Si Thu Pyae Phyo Wai Sandar Aye Saw Saw Htet Myet Win Maung Si Thu Aung Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar Tropical Medicine and Infectious Disease contacts contact tracing contact investigation mdr-tb |
author_facet |
Aye Mon Phyo Ajay M. V. Kumar Kyaw Thu Soe Khine Wut Yee Kyaw Aung Si Thu Pyae Phyo Wai Sandar Aye Saw Saw Htet Myet Win Maung Si Thu Aung |
author_sort |
Aye Mon Phyo |
title |
Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar |
title_short |
Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar |
title_full |
Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar |
title_fullStr |
Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar |
title_full_unstemmed |
Contact Investigation of Multidrug-Resistant Tuberculosis Patients: A Mixed-Methods Study from Myanmar |
title_sort |
contact investigation of multidrug-resistant tuberculosis patients: a mixed-methods study from myanmar |
publisher |
MDPI AG |
series |
Tropical Medicine and Infectious Disease |
issn |
2414-6366 |
publishDate |
2019-12-01 |
description |
There is no published evidence on contact investigation among multidrug-resistant tuberculosis (MDR-TB) patients from Myanmar. We describe the cascade of contact investigation conducted in 27 townships of Myanmar from January 2018 to June 2019 and its implementation challenges. This was a mixed-methods study involving quantitative (cohort analysis of programme data) and qualitative components (thematic analysis of interviews of 8 contacts and 13 health care providers). There were 556 MDR-TB patients and 1908 contacts, of whom 1134 (59%) reached the health centres for screening (chest radiography and symptoms). Of the latter, 344 (30%) had presumptive TB and of them, 186 (54%) were investigated (sputum microscopy or Xpert MTB/RIF<sup>®</sup>). A total of 27 TB patients were diagnosed (six bacteriologically-confirmed including five with rifampicin resistance). The key reasons for not reaching township TB centres included lack of knowledge and lack of risk perception owing to wrong beliefs among contacts, financial constraints related to loss of wages and transportation charges, and inconvenient clinic hours. The reasons for not being investigated included inability to produce sputum, health care providers being unaware of or not agreeing to the investigation protocol, fixed clinic days and times, and charges for investigation. The National Tuberculosis Programme needs to note these findings and take necessary action. |
topic |
contacts contact tracing contact investigation mdr-tb |
url |
https://www.mdpi.com/2414-6366/5/1/3 |
work_keys_str_mv |
AT ayemonphyo contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT ajaymvkumar contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT kyawthusoe contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT khinewutyeekyaw contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT aungsithu contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT pyaephyowai contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT sandaraye contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT sawsaw contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT htetmyetwinmaung contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar AT sithuaung contactinvestigationofmultidrugresistanttuberculosispatientsamixedmethodsstudyfrommyanmar |
_version_ |
1724798167455629312 |