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Article
Publication date: 14 October 2013

Ugochukwu Uchenna Onyeonoro, Joseph Ngozi Chukwu, Charles C. Nwafor, Anthony O. Meka and Daniel C. Oshi

In 2007, Nigeria commenced a nationwide behavioural change communication (BCC) intervention to increase uptake of tuberculosis (TB) care services. The purpose of this…

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Abstract

Purpose

In 2007, Nigeria commenced a nationwide behavioural change communication (BCC) intervention to increase uptake of tuberculosis (TB) care services. The purpose of this paper is to evaluate the effect of TB BCC intervention on knowledge and perception of TB in Enugu state, southeast Nigeria.

Design/methodology/approach

This is a cross-sectional study carried out in December 2009 in which a total of 1,200 respondents (620 males and 580 females) from six local government areas (three urban and three rural), selected by multi-stage sampling technique were interviewed using a semi-structured questionnaire.

Findings

The survey showed that most of the respondents had access to radio and about half to television. Access to media was significantly higher in urban areas than rural areas. Radio and community were the commonest sources of information of TB. The majority of the respondents were aware of that there was a message, however, ability to recall the content of the message varied. Significant association was observed between knowledge of the health education message and knowledge of TB transmission, that TB is curable and of appropriate care-seeking behaviour. Access to this media health education intervention was determined by age, gender, educational status, literacy, religion and access to media.

Practical implications

The study showed that TB BCC is associated with high-level awareness of TB disease and appropriate care-seeking behaviour. Socio-demographic characteristics and locality were found to influence access to mass media communication. Therefore, consideration should be given to the appropriateness of medium of communication in the design of TB BCC. However, there is need to combine it with other strategies to reach the disadvantaged population.

Originality/value

This study is the first population-based survey to ascertain access to TB-related BCC intervention and its effect on knowledge and care-seeking behaviour of this study population.

Details

Health Education, vol. 113 no. 6
Type: Research Article
ISSN: 0965-4283

Keywords

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Article
Publication date: 16 April 2018

Sasithorn Tangsawad and Surasak Taneepanichskul

The purpose of this paper is to study the efficacy of a district tuberculosis (TB) co-ordinating team on health service performance for suspected TB patients in a district…

Abstract

Purpose

The purpose of this paper is to study the efficacy of a district tuberculosis (TB) co-ordinating team on health service performance for suspected TB patients in a district hospital in northeastern Thailand.

Design/methodology/approach

A comparison study of pre- and post-evaluations of TB system improvement was conducted in a district hospital in northeastern Thailand between October 2016 and June 2017. Data collection reviewed the record of suspected TB cases reported in the district hospital in the past nine months as a base line for describing the health service performance in term of received investigation for TB diagnosis. Participants from a TB clinic, district health office and health center set up a TB co-ordinating team to explore situations and systematic gaps. The TB co-ordinating team gave recommendations of health service performance for suspected TB patients over a nine-month period. Records of suspected TB cases health service performance were collected nine months after intervention. Data analysis by descriptive statistics and to test the effect of intervention was performed.

Findings

The records from 324 and 379 suspected TB cases reported in the hospital from the 9 months preceding and 9 months, respectively, after intervention were reviewed. A TB co-ordinating team was set up to improve the system and health service performance in terms of investigation for TB diagnosis. The results revealed that health service performance in terms of complete microscopy and investigation in both chest radiography and microscopy increased after intervention. When comparing between pre- and post-intervention, suspected cases received both chest radiography and microscopy in 176 cases and 283 cases, respectively (p-value=0.001). There were 27 cases diagnosed for smear positive TB in pre-intervention and 51 cases diagnosed in post-intervention (p-value=0.011). There were 21 cases pre- and 36 cases post-intervention that had referral documents from health center with no statistically significant difference.

Originality/value

The TB co-ordinating team had the role to improve health service performance for suspected TB cases to enroll in investigation process for increase TB diagnosis in district hospital.

Details

Journal of Health Research, vol. 32 no. 3
Type: Research Article
ISSN: 2586-940X

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Article
Publication date: 6 November 2007

Allaby Martin, Christine Preston, Laxmi Byanjankar, Dirga S. Bam, Shanta Bahadur Pande, Sushil Chandra Baral and James N. Newell

The purpose of the paper is to show that, despite comprehensive coverage of services for TB provided by a public‐private partnership for TB control in Patan, a city in…

Abstract

Purpose

The purpose of the paper is to show that, despite comprehensive coverage of services for TB provided by a public‐private partnership for TB control in Patan, a city in Nepal, case finding is low, compared with the target based on an Annual Risk of Tuberculosis Infection (ARTI) of 4 per cent. Doubts have been raised as to the appropriateness of the target. The objective of the study was to estimate the number of new TB cases occurring in Patan, to assess whether the target was appropriate.

Design/methodology/approach

In the paper doorstep interviews were conducted with all households in the study area, followed by in‐depth interviews of households with possible or probable TB cases. The survey findings were validated against the patient registers of the five DOTS centres in Patan.

Findings

The paper finds that, among the study population of 36,918, the household survey identified 17 smear‐positive TB cases (none privately‐treated) and 24 smear‐negative/extra‐pulmonary cases (including four privately‐treated cases). Validation against the DOTS patient registers indicated that the survey was 54 per cent complete. After adjusting for incompleteness, the number of smear‐positive cases in the study area was estimated as 31, equivalent to an incidence of 85 smear positives per 100,000 population and an ARTI of 1.7 per cent.

Originality/value

The paper shows that using the ARTI may lead to misleadingly high targets for urban TB control. Unrealistically high targets may cause TB workers to become demoralised, and useful strategies to be abandoned. Therefore, further work is needed to identify better ways of setting targets.

Details

Journal of Health Organization and Management, vol. 21 no. 6
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 5 October 2021

Palka Mittal, Puneeta Ajmera, Vineet Jain and Gaurav Aggarwal

Tuberculosis (TB) continues to c-exist with humans despite many TB control programs and elimination strategies. This depicts that some barriers are not allowing achieving…

Abstract

Purpose

Tuberculosis (TB) continues to c-exist with humans despite many TB control programs and elimination strategies. This depicts that some barriers are not allowing achieving the desired results. The current study aims to focus on identification and ranking of such barriers to facilitate TB control programs in developing countries.

Design/methodology/approach

In the present study, 13 barriers that can influence success rate of TB elimination strategies have been recognized with an in-depth assessment of related literature and opinions of specialists from medical industry and academic world. The interpretive structural modeling (ISM) and decision-making trial and evaluation laboratory (DEMATEL) techniques have been employed for the ranking of barriers.

Findings

Based on driving power of barriers, the study coined that underinvestment is a major barrier followed by poor implementation of government policies and programs, poverty and poor primary health care infrastructure.

Research limitations/implications

The findings may guide healthcare service providers and researchers in analyzing the barriers and understanding the necessity of further advancements to decrease the count of already existing and incident cases.

Practical implications

Policy- and decision-makers may utilize the information on dependence and driving power of barriers for better planning and effective execution of TB control strategies.

Originality/value

Although a lot of literature is available on different barriers that are affecting success of TB strategies, the current study analyzes all the key barriers collectively for the prioritization of barriers.

Details

International Journal of Health Governance, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 3 August 2021

Bastian Kordyaka and Björn Kruse

The purpose of this paper is to investigate toxic behaviour (TB) that significantly harms individuals’ gameplay experience in multiplayer online video games. Multiplayer…

Abstract

Purpose

The purpose of this paper is to investigate toxic behaviour (TB) that significantly harms individuals’ gameplay experience in multiplayer online video games. Multiplayer online video games allow to simultaneously interact with others in real time. They can be considered as digital communities unifying a group of players within a video game. TB is characterized by spreading a bad mood (e.g. upsetting and insulting) leading to unsatisfying outcomes in team-based multiplayer environments.

Design/methodology/approach

Using mixed methods, the authors show that handling TB should be addressed more firmly on a level of game design. First, the authors test the explanatory power of the online disinhibition effect (ODE) and its antecedents on TB using a quantitative survey (N = 320) and structural equation modelling. Specifically, the authors show that dissociative anonymity, asynchronicity, solipsistic introjection, dissociative imagination and minimization of authority have a mediated effect through toxic disinhibition as predictors of TB. Second, the authors conduct a focus group workshop (N = 10) with experts from diverse disciplines to derive design principles on a level of game design.

Findings

The results indicate that transparency and imminent feedback are still underutilized elements in game design that can significantly buffer several forms of TB. By developing a heuristic prototype and exemplary design principles in subsequent categories, the authors address all relevant in-game scenarios. With this study, the authors provide researchers and practitioners helpful insights on how to increase the well-being and safety of gaming communities.

Originality/value

ODE already showed its explanatory potential in the neighbouring context of cyberbullying. Embedded in theories of negative behaviour on the internet, the authors propose a holistic and theory-driven approach to handle TB on a level of game design. The authors’ insights allow for a better understanding of an innovative entity of the dark side of technology diffusion and adverse side effects linked to it.

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Article
Publication date: 15 June 2021

Bumi Herman, Wandee Sirichokchatchawan, Chanin Nantasenamat and Sathirakorn Pongpanich

The Chulalongkorn-Hasanuddin Rifampicin-Resistant Tuberculosis Screening Tool (CUHAS-ROBUST) is an artificial intelligence–based (AI–based) application for…

Abstract

Purpose

The Chulalongkorn-Hasanuddin Rifampicin-Resistant Tuberculosis Screening Tool (CUHAS-ROBUST) is an artificial intelligence–based (AI–based) application for rifampicin-resistant tuberculosis (RR-TB) screening. This study aims to elaborate on the drug-resistant TB (DR-TB) problem and the impact of CUHAS-ROBUST implementation on RR-TB screening.

Design/methodology/approach

A qualitative approach with content analysis was performed from September 2020 to October 2020. Medical staff from the primary care center were invited online for application trials and in-depth video call interviews. Transcripts were derived as a data source. An inductive thematic data saturation technique was conducted. Descriptive data of participants, user experience and the impact on the health service were summarized

Findings

A total of 33 participants were selected from eight major islands in Indonesia. The findings show that DR-TB is a new threat, and its diagnosis faces obstacles particularly prolonged waiting time and inevitable delayed treatment. Despite overcoming the RR-TB screening problems with fast prediction, the dubious screening performance, and the reliability of data collection for input parameters were the main concerns of CUHAS-ROBUST. Nevertheless, this application increases the confidence in decision-making, promotes medical procedure compliance, active surveillance and enhancing a low-cost screening approach.

Originality/value

The CUHAS-ROBUST achieved its purpose as a tool for clinical decision-making in RR-TB screening. Moreover, this study demonstrates AI roles in enhancing health-care quality and boost public health efforts against tuberculosis.

Details

Journal of Health Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0857-4421

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Book part
Publication date: 26 August 2014

Julia Fan Li and Elizabeth Garnsey

Healthcare innovations for bottom-of-pyramid populations face considerable risks and few economic incentives. Can entrepreneurial innovators provide new solutions for…

Abstract

Healthcare innovations for bottom-of-pyramid populations face considerable risks and few economic incentives. Can entrepreneurial innovators provide new solutions for global health? This chapter examines how a technology enterprise built a collaborative network and supportive ecosystem making it possible to steer an innovation for TB patients through discovery, development, and delivery. Ecosystem resources were mobilized and upstream and downstream co-innovation risks were mitigated to commercialize a new diagnostic test. Detailed evidence on this innovation for TB care uses ecosystem analysis to clarify core issues in the context of joint value creation. The case study shows how resources from private and public partners can be leveraged and combined by the focal firm to build joint value and to lower execution, co-innovation, and adoption risks in healthcare ecosystems combating diseases of poverty.

Details

Collaboration and Competition in Business Ecosystems
Type: Book
ISBN: 978-1-78190-826-6

Keywords

Content available
Article
Publication date: 18 March 2021

Theint Theint Lwin, Tawatchai Apidechkul, Jongkon Saising, Panupong Upala and Ratipark Tamornpark

This qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar…

Abstract

Purpose

This qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on the Thailand-Myanmar border.

Design/methodology/approach

Twenty-two participants were asked to provide information. In-depth interviews were used to gather the information. Each interview lasted 40 min.

Findings

TB patients from Myanmar experience several barriers to accessing TB treatment and care at Mae Sai Hospital, such as language and economic problems, although they are very satisfied with the quality of service and positive attitude of the health care providers. A long waiting time and lack of explanation of the pathogenesis of TB were noted as negative aspects by the patients and their relatives. The medical staff at the TB clinic were negatively affected by the excessive workload and unsuitability of some methods or technologies. Using budgetary subsidies from agencies to fund TB care and treatment was not sustainable. Foreign TB patients are not subsidized by the national universal insurance scheme of Thailand, and sending TB patients back to their home country is sometimes unavoidable.

Originality/value

Thailand and Myanmar should strengthen their collaboration and develop a system to improve the quality of TB patient care and management for those who are living in poverty and lack education, by focusing on reducing language and economic barriers to accessing health care services including support for medicines and laboratory materials related to TB case management among these populations.

Details

Journal of Health Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0857-4421

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Book part
Publication date: 9 August 2012

Angélica Forero-Quintana and Sara E. Grineski

Purpose – One-third of the world's population is infected with tuberculosis (TB) and there are two million TB-related deaths worldwide every year. Along the U.S.-Mexico…

Abstract

Purpose – One-third of the world's population is infected with tuberculosis (TB) and there are two million TB-related deaths worldwide every year. Along the U.S.-Mexico border, migration patterns, and reduced access to health care contribute to high rates of TB. Delayed diagnosis of TB, the focus of this chapter, increases the likelihood that a patient will progress to more advanced stages of the disease and heightens the risk of TB transmission to others as patients are contagious for longer periods of time.

Approach – Despite the seriousness of these consequences, few sociological studies have examined delayed diagnosis of TB and why people affected by TB symptoms delay care. Because of this, we take a health narratives approach to understanding the experiences of 15 TB patients of Mexican descent in a high-risk border community (e.g., El Paso, Texas) in order to discover why delayed diagnoses happen and how they impact patients.

Findings – Fourteen of the fifteen patients experienced delayed diagnosis. Analysis of these fourteen narratives revealed two broad themes: (1) provider lack of awareness, including repeated misdiagnosis and TB test errors, and (2) patient disadvantage, including fear of U.S. immigration authorities and few economic resources for care.

Implications – Findings from this study suggest that prompt diagnosis of TB could be achieved if providers were more cognizant of TB and its symptoms and public health policies increased access to health care regardless of immigration status or socioeconomic status.

Details

Issues in Health and Health Care Related to Race/Ethnicity, Immigration, SES and Gender
Type: Book
ISBN: 978-1-78190-125-0

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Article
Publication date: 12 August 2020

Ayat Ahmadi, Leila Doshmangir, Vladimir Sergeevich Gordeev, Bahareh Yazdizadeh and Reza Majdzadeh

Underreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private…

Abstract

Purpose

Underreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private sector in TB cases diagnosing. The purpose of this paper was to explore behavioral determinants of underreporting of new TB cases among private sector physicians in Iran.

Design/methodology/approach

The authors conducted a population-based, cross-sectional study of physicians working in private clinics. The data collection tool was designed using the theory of planned behavior (TPB). The authors used structural equation models with maximum likelihood estimation to examine attitude toward the notification behavior.

Findings

Of 519 physicians, 433 physicians completed the questionnaire. Attitude toward notification had the highest score (mean score = 87.65; sd = 6.79; range: 0–100). The effect of perceived behavioral controls on the notification behavior ((β^) = 0.13; CI: 0.01–0.25) was stronger than the total effect of attitude ((β^) = 0.06; CI: 0.00–0.12) and subjective norms ((β^) = 0.01; CI: −0.00–0.03) on the behavior. However, the attitude was the main predictor of intention and justified 46% of the intention variance. Intention had a significant effect on the behavior ((ß^) = 0.09; CI: 0.1–0.16).

Practical implications

Considering stronger effect of perceived behavioral control on the behavior, interventions aiming at facilitating notification process would be more effective than those aiming at changing the attitude or enhancing intention among physicians.

Originality/value

To the best of our knowledge, no other study previously explored determinants of underreporting from the behavioral and cognitive perspective. Specifically, the authors explored the role of the TPB constructs in predicting intention to notify new TB cases.

Details

International Journal of Health Governance, vol. 25 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

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