Healthcare workers’ fears associated with working in multidrug-and or extensively-resistant TB wards in South Africa
International Journal of Tuberculosis and Lung Disease
Authors:Tudor, C., Mphahlele, M., Van der Walt, M., & Farley, J. E.
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.