Human resource implications of expanding latent tuberculosis patient care activities.

Autor:	Alsdurf H; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.; McGill International TB Centre, McGill University, Montreal, QC, Canada., Benedetti A; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.; McGill International TB Centre, McGill University, Montreal, QC, Canada., Buu TN; Woolcock Institute of Medical Research, Hanoi, Vietnam., Adjobimey M; Programme National Contre la Tuberculose, Centre National Hospitalier Universitaire de Pneumo-Phtisiologie, Cotonou, Benin., Cook VJ; Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada.; Department of Medicine, University of British Columbia, Vancouver, BC, Canada., Fisher D; Division of Respiratory Medicine, University of Calgary, Calgary, AB, Canada., Fox G; The University of Sydney Central Clinical School, The Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia., Fregonese F; McGill International TB Centre, McGill University, Montreal, QC, Canada., Hadisoemarto P; Department of Public Health, Faculty of Medicine, TB-HIV Research Center, Universitas Padjadjaran, Bandung, Indonesia., Johnston J; Provincial Tuberculosis Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada., Long R; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada., Obeng J; Chest Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Oxlade O; McGill International TB Centre, McGill University, Montreal, QC, Canada.; Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada., Ruslami R; Department of Biomedical Sciences, Division of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia., Schwartzman K; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.; McGill International TB Centre, McGill University, Montreal, QC, Canada.; Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada., Strumpf E; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada., Menzies D; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.; McGill International TB Centre, McGill University, Montreal, QC, Canada.; Respiratory Epidemiology and Clinical Research Unit (RECRU), McGill University, Montreal, QC, Canada.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2024 Jan 12; Vol. 10, pp. 1265476. Date of Electronic Publication: 2024 Jan 12 (Print Publication: 2023).
DOI:	10.3389/fmed.2023.1265476
Abstrakt:	Introduction: The World Health Organization (WHO) declared increasing services for latent tuberculosis infection (LTBI) a priority to eliminate tuberculosis (TB) by 2035. Yet, there is little information about thehuman resource needs required to implement LTBI treatment scale-up. Our study aimed to estimate the change in healthcare workers (HCW) time spent on different patient care activities, following an intervention to strengthen LTBI services. Methods: We conducted a time and motion (TAM) study, observing HCW throughout a typical workday before and after the intervention (Evaluation and Strengthening phases, respectively) at 24 health facilities in five countries. The precise time spent on pre-specified categories of work activities was recorded. Time spent on direct patient care was subcategorized as relating to one of three conditions: LTBI, active or suspected TB, and non-TB (i.e., patients with any other medical condition). A linear mixed model (LMM) was fit to estimate the change in HCW time following the intervention. Results: A total of 140 and 143 HCW participated in the TAMs during the Evaluation and Strengthening phases, respectively. Results from intervention facilities showed an increase of 9% (95% CI: 3%, 15%) in the proportion of HCW time spent on LTBI-related services, but with a corresponding change of -11% (95% CI: -21%, -1%) on active TB services. There was no change in the proportion of time spent on LTBI care in control facilities; this remained low in both phases of the study. Discussion: Our findings suggest that additional HCW personnel will be required for expansion of LTBI services to ensure that this expansion does not reduce the time available for care of active TB patients. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Alsdurf, Benedetti, Buu, Adjobimey, Cook, Fisher, Fox, Fregonese, Hadisoemarto, Johnston, Long, Obeng, Oxlade, Ruslami, Schwartzman, Strumpf and Menzies.)
Databáze:	MEDLINE
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