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[ID] => 1414
[post_author] => 4
[post_date] => 2021-03-23 22:51:32
[post_date_gmt] => 2021-03-24 02:51:32
[post_content] =>
Abstract
Background
In 2011, Médecins Sans Frontières (MSF) established a blogging project, “TB&Me,” to enable patients with multidrug-resistant tuberculosis (MDR-TB) to share their experiences. By September 2012, 13 MDR-TB patients had blogged, either directly or with assistance, from the UK, Australia, Philippines, Swaziland, Central African Republic, Uganda, South Africa, India, and Armenia. Due to the lack of research on the potential for social media to support MDR-TB treatment and the innovative nature of the blog, we decided to conduct a qualitative study to examine patient and staff experiences. Our aim was to identify potential risks and benefits associated with blogging to enable us to determine whether social media had a role to play in supporting patients with MDR-TB.
Methods and Findings
Participants were identified and selected purposively. TB&Me bloggers, project staff, MSF headquarters staff involved with TB and WHO European Region TB policy advisors were invited to participate in a semi-structured interview. Twenty interviews were conducted (five with bloggers). Data analysis drew upon principles of grounded theory, with constant comparison of data, cases and categories, and attention to deviant cases. We found that the TB&Me blog was associated with identified health benefits, with no reported instances of harm. There were three main findings: blogging was reported as useful for adherence to DR-TB treatment and supportive of the treatment-taking process by all bloggers and project staff; blogging provided support to patients (peer support, shared experience and reduction in isolation); and the blog was perceived as giving patients strength and voice.
Conclusion
The TB&Me blog was seen to be associated with positive identified health and emotional benefits. Component 5 of the Stop TB Global Plan highlights the importance of empowering TB patients and communities. Blogging could be a useful tool to help achieve that ambition.
[post_title] => “I Can Also Serve as an Inspiration”: A Qualitative Study of the TB&Me Blogging Experience and Its Role in MDR-TB Treatment
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
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[post_name] => i-can-also-serve-as-an-inspiration-a-qualitative-study-of-the-tbme-blogging-experience-and-its-role-in-mdr-tb-treatment
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[post_modified] => 2021-03-23 22:51:32
[post_modified_gmt] => 2021-03-24 02:51:32
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[guid] => https://sshiftb.org/?post_type=resources&p=1414
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[1] => WP_Post Object
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[ID] => 1475
[post_author] => 4
[post_date] => 2021-04-06 12:49:37
[post_date_gmt] => 2021-04-06 16:49:37
[post_content] =>
Abstract
Background
Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF (‘Xpert’)—a rapid molecular assay with high sensitivity and specificity—for pediatric presumptive TB patients, as recommended by India’s Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers.
Methods
We conducted semi-structured interviews with a sample of health providers from public and private sectors engaged in the ongoing pediatric project in 4 major cities of India. Providers were sampled from intervention data based on sector of practice, number of Xpert referrals, and TB detection rates amongst referrals. A total of 55 providers were interviewed with different levels of FOC Xpert testing uptake. Data were transcribed and analyzed inductively by a medical anthropologist using thematic content analysis and narrative analysis.
Results
It was observed that despite guidance from RNTCP on the use of Xpert and significant efforts by FIND and state authorities to disseminate these guidelines, there was notable diversity in their implementation by different health care providers. Xpert, apart from being utilized as intended, i.e. as a first diagnostic test for children, was utilized variably–as an initial screening test (to rule out TB), confirmatory test (once TB diagnosis is established based on antibiotic trial or clinically) and/or only for drug susceptibility testing after TB diagnosis was confirmed. Most providers who used Xpert frequently reported that Xpert was an important tool for managing pediatric TB cases, by reducing the proportion of cases diagnosed only on clinical suspicion and by providing upfront information on drug resistance, which is seldom suspected in children. Despite non-standard use, these results showed that Xpert access helped raise awareness, aided in antibiotic stewardship, and reduced dependence on clinical diagnosis among those who diagnose and treat TB in children.
Conclusion
Access to free and rapid Xpert testing for all presumptive pediatric TB patients has had multiple positive effects on pediatricians’ diagnosis and treatment of TB. It has important effects on speed of diagnosis, empirical treatment, and awareness of drug resistance among TB treatment naive children. In addition, our study shows that access to public sector Xpert machines may be an important way to encourage Public-Private integration and facilitate the movement of patients from the private to public sector for anti-TB treatment. Despite availability of rapid and free Xpert testing, our study showed an alarming diversity of Xpert utilization strategies across different providers who may be moving toward suggested practice over time. The degree of diversity in TB diagnostic approaches in children reported here highlights the urgent need for concerted efforts to place Xpert early in diagnostic algorithms to positively impact the pediatric TB care pathway. A positive change in diagnostic algorithms may be possible with continued advocacy, time, and increased access.
[post_title] => “Before Xpert I only had my expertise”: A qualitative study on the utilization and effects of Xpert technology among pediatricians in 4 Indian cities
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
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[post_name] => before-xpert-i-only-had-my-expertise-a-qualitative-study-on-the-utilization-and-effects-of-xpert-technology-among-pediatricians-in-4-indian-cities
[to_ping] =>
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[post_modified] => 2021-04-06 12:50:49
[post_modified_gmt] => 2021-04-06 16:50:49
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[2] => WP_Post Object
(
[ID] => 1422
[post_author] => 5
[post_date] => 2021-03-24 00:58:54
[post_date_gmt] => 2021-03-24 04:58:54
[post_content] => In commemoration of World TB Day March 24th, 2021,the International Journal of Infectious Diseases is publishing a specific TB Theme issue of 18 articles covering a range of topics.
[post_title] => World TB Day 2021 Int J Infect Dis Special Issue
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => world-tb-day-2021-int-j-infect-dis-special-issue
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[post_modified] => 2021-03-24 01:14:38
[post_modified_gmt] => 2021-03-24 05:14:38
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[3] => WP_Post Object
(
[ID] => 1200
[post_author] => 5
[post_date] => 2021-03-02 15:46:50
[post_date_gmt] => 2021-03-02 20:46:50
[post_content] => Women requiring TB care face a range of critical issues and this call to action urges innovators and researchers to develop gender-transformative interventions for TB.
[post_title] => Women and TB: a call to action
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => women-and-tb-a-call-to-action
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-09 21:38:54
[post_modified_gmt] => 2021-03-10 02:38:54
[post_content_filtered] =>
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[guid] => http://sshiftb.org/?post_type=resources&p=1200
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[4] => WP_Post Object
(
[ID] => 1413
[post_author] => 4
[post_date] => 2021-03-23 22:47:05
[post_date_gmt] => 2021-03-24 02:47:05
[post_content] => Abstract
Background
Treatment for multi-drug resistant tuberculosis (MDR-TB) is lengthy, has severe side effects, and raises adherence challenges. In the Médecins Sans Frontières (MSF) and Ministry of Health (MoH) programme in Karakalpakstan, Uzbekistan, a region with a high burden of MDR-TB, patient loss from treatment (LFT) remains high despite adherence support strategies. While certain factors associated with LFT have been identified, there is limited understanding of why some patients are able to adhere to treatment while others are not. We conducted a qualitative study to explore patients’ experiences with MDR-TB treatment, with the aim of providing insight into the barriers and enablers to treatment-taking to inform future strategies of adherence support.
Methods
Participants were purposively selected. Programme data were analysed to enable stratification of patients by adherence category, gender, and age. 52 in-depth interviews were conducted with MDR-TB patients (n = 35) and health practitioners (n = 12; MSF and MoH doctors, nurses, and counsellors), including five follow-up interviews. Interview notes, then transcripts, were analysed using coding to identify emerging patterns and themes. Manual analysis drew upon principles of grounded theory with constant comparison of codes and categories within and between cases to actively seek discrepancies and generate concepts from participant accounts. Ethics approval was received from the MoH of the Republic of Uzbekistan Ethics Committee and MSF Ethics Review Board.
Results
Several factors influenced adherence. Hope and high quality knowledge supported adherence; autonomy and control enabled optimal engagement with treatment-taking; and perceptions of the body, self, treatment, and disease influenced drug tolerance. As far as we are aware, the influence of patient autonomy and control on MDR-TB treatment-taking has not previously been described. In particular, the autonomy of married women around treatment-taking was potentially undermined through their societal position as daughter-in-law, compromising their ability to adhere to treatment. Patients’ engagement with and adherence to treatment could be hindered by hierarchical practitioner-patient relationships that displaced authority, ownership, and responsibility from the patient.
Conclusions
Our findings reinforce the need for an individualised and holistic approach to adherence support with engagement of patients as active participants in their care who feel ownership and responsibility for their treatment.
[post_title] => Where there is hope: a qualitative study examining patients’ adherence to multi-drug resistant tuberculosis treatment in Karakalpakstan, Uzbekistan
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => where-there-is-hope-a-qualitative-study-examining-patients-adherence-to-multi-drug-resistant-tuberculosis-treatment-in-karakalpakstan-uzbekistan
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-23 22:47:05
[post_modified_gmt] => 2021-03-24 02:47:05
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://sshiftb.org/?post_type=resources&p=1413
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[5] => WP_Post Object
(
[ID] => 1402
[post_author] => 4
[post_date] => 2021-03-23 17:22:45
[post_date_gmt] => 2021-03-23 21:22:45
[post_content] =>
Abstract
Until recently, human rights have played a minor role in the fight against tuberculosis (TB), even less so in TB research. This is changing, however. The WHO's End TB Strategy and Ethics Guidance stress respect for human rights and ethical principles in every area of TB care, including research. The desired reductions in TB incidence and mortality are impossible without new tools and strategies to fight the disease. Yet, little suggests that the current state of TB research-including funding levels, evidence being produced, and community involvement-will alleviate concerns related to the availability, accessibility, and acceptability of TB diagnostics, drugs, and prevention in the near future. In this article, we consider these ethics concerns in relation to the right to enjoy the benefits of scientific progress and the right to health. We also reflect on community involvement in research and offer recommendations in the spirit of the rights to health and science, such as involving affected communities in all aspects of research planning, execution, and dissemination. Finally, we argue that states have a responsibility under international law for the continued realization of the right to health. This realization rests, in part, on the realization of the right to science.
[post_title] => Upholding ethical values and human rights at the frontier of TB research
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => upholding-ethical-values-and-human-rights-at-the-frontier-of-tb-research
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-23 17:22:45
[post_modified_gmt] => 2021-03-23 21:22:45
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://sshiftb.org/?post_type=resources&p=1402
[menu_order] => 0
[post_type] => resources
[post_mime_type] =>
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[6] => WP_Post Object
(
[ID] => 1417
[post_author] => 4
[post_date] => 2021-03-23 23:01:08
[post_date_gmt] => 2021-03-24 03:01:08
[post_content] =>
Abstract
Until recently, human rights have played a minor role in the fight against tuberculosis (TB), even less so in TB research. This is changing, however. The WHO's End TB Strategy and Ethics Guidance stress respect for human rights and ethical principles in every area of TB care, including research. The desired reductions in TB incidence and mortality are impossible without new tools and strategies to fight the disease. Yet, little suggests that the current state of TB research—including funding levels, evidence being produced, and community involvement—will alleviate concerns related to the availability, accessibility, and acceptability of TB diagnostics, drugs, and prevention in the near future. In this article, we consider these ethics concerns in relation to the right to enjoy the benefits of scientific progress and the right to health. We also reflect on community involvement in research and offer recommendations in the spirit of the rights to health and science, such as involving affected communities in all aspects of research planning, execution, and dissemination. Finally, we argue that states have a responsibility under international law for the continued realization of the right to health. This realization rests, in part, on the realization of the right to science.
[post_title] => Upholding ethical values and human rights at the frontier of TB research
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => upholding-ethical-values-and-human-rights-at-the-frontier-of-tb-research-2
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-23 23:01:08
[post_modified_gmt] => 2021-03-24 03:01:08
[post_content_filtered] =>
[post_parent] => 0
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[7] => WP_Post Object
(
[ID] => 1420
[post_author] => 4
[post_date] => 2021-03-23 23:28:40
[post_date_gmt] => 2021-03-24 03:28:40
[post_content] =>
[post_title] => Unknown Unknowns: Poverty and Tuberculosis in Romania
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => unknown-unknowns-poverty-and-tuberculosis-in-romania
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-23 23:28:40
[post_modified_gmt] => 2021-03-24 03:28:40
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[8] => WP_Post Object
(
[ID] => 1197
[post_author] => 5
[post_date] => 2021-03-02 12:21:03
[post_date_gmt] => 2021-03-02 17:21:03
[post_content] => Listen to this
podcast about tuberculosis produced in Jan 2020 by
Raw Talk, a graduate student-run podcast at the University of Toronto about medical science, and the people who make it happen. This episode features Dr. Jun Liu, Professor in the Department of Molecular Genetics at University of Toronto,
Dr. Amrita Daftary, Professor in the School of Global Health at York University, and Dr. Sarah Fortune, Director of TB Research Program at Harvard T. H. Chan School of Public Health.
[post_title] => Tuberculosis: The Forgotten Pandemic
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => tuberculosis-the-forgotten-pandemic
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-06 07:47:48
[post_modified_gmt] => 2021-03-06 12:47:48
[post_content_filtered] =>
[post_parent] => 0
[guid] => http://sshiftb.org/?post_type=resources&p=1197
[menu_order] => 0
[post_type] => resources
[post_mime_type] =>
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[9] => WP_Post Object
(
[ID] => 1099
[post_author] => 4
[post_date] => 2016-10-14 00:00:29
[post_date_gmt] => 2016-10-14 04:00:29
[post_content] =>
Abstract
Tuberculosis (TB)-related stigma is an important social determinant of health. Research generally highlights how stigma can have a considerable impact on individuals and communities, including delays in seeking health care and adherence to treatment. There is scant research into the assessment of TB related stigma in low incidence countries. This study aimed to systematically map out the research into stigma. A particular emphasis was placed on the methods employed to measure stigma, the conceptual frameworks used to understand stigma, and whether structural factors were theorized. Twenty-two studies were identified; the majority adopted a qualitative approach and aimed to assess knowledge, attitudes, and beliefs about TB. Few studies included stigma as a substantive topic. Only one study aimed to reduce stigma. A number of studies suggested that TB control measures and representations of migrants in the media reporting of TB were implicated in the production of stigma. The paucity of conceptual models and theories about how the social and structural determinants intersect with stigma was apparent. Future interventions to reduce stigma, and measurements of effectiveness, would benefit from a stronger theoretical underpinning in relation to TB stigma and the intersection between the social and structural determinants of health.
[post_title] => Tuberculosis Stigma as a social determinant of health: a systematic mapping review of research in low incidence countries
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => tuberculosis-stigma-as-a-social-determinant-of-health-a-systematic-mapping-review-of-research-in-low-incidence-countries
[to_ping] =>
[pinged] =>
[post_modified] => 2021-03-04 22:04:24
[post_modified_gmt] => 2021-03-05 03:04:24
[post_content_filtered] =>
[post_parent] => 0
[guid] => http://sshiftb.org/?post_type=resources&p=1099
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)
)
[post_count] => 10
[current_post] => -1
[in_the_loop] =>
[post] => WP_Post Object
(
[ID] => 1414
[post_author] => 4
[post_date] => 2021-03-23 22:51:32
[post_date_gmt] => 2021-03-24 02:51:32
[post_content] =>
Abstract
Background
In 2011, Médecins Sans Frontières (MSF) established a blogging project, “TB&Me,” to enable patients with multidrug-resistant tuberculosis (MDR-TB) to share their experiences. By September 2012, 13 MDR-TB patients had blogged, either directly or with assistance, from the UK, Australia, Philippines, Swaziland, Central African Republic, Uganda, South Africa, India, and Armenia. Due to the lack of research on the potential for social media to support MDR-TB treatment and the innovative nature of the blog, we decided to conduct a qualitative study to examine patient and staff experiences. Our aim was to identify potential risks and benefits associated with blogging to enable us to determine whether social media had a role to play in supporting patients with MDR-TB.
Methods and Findings
Participants were identified and selected purposively. TB&Me bloggers, project staff, MSF headquarters staff involved with TB and WHO European Region TB policy advisors were invited to participate in a semi-structured interview. Twenty interviews were conducted (five with bloggers). Data analysis drew upon principles of grounded theory, with constant comparison of data, cases and categories, and attention to deviant cases. We found that the TB&Me blog was associated with identified health benefits, with no reported instances of harm. There were three main findings: blogging was reported as useful for adherence to DR-TB treatment and supportive of the treatment-taking process by all bloggers and project staff; blogging provided support to patients (peer support, shared experience and reduction in isolation); and the blog was perceived as giving patients strength and voice.
Conclusion
The TB&Me blog was seen to be associated with positive identified health and emotional benefits. Component 5 of the Stop TB Global Plan highlights the importance of empowering TB patients and communities. Blogging could be a useful tool to help achieve that ambition.
[post_title] => “I Can Also Serve as an Inspiration”: A Qualitative Study of the TB&Me Blogging Experience and Its Role in MDR-TB Treatment
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