Tuberculosis diagnostics: Why we need more qualitative research
Summary
Published May 2013.
After decades of neglect, the field of tuberculosis (TB) diagnostics is advancing. New tests have been developed and evaluated, existing ones are being adapted for new contexts, and decision-makers have a rich pipeline to choose from and invest in [1]. Yet, some important gaps remain, including the need for a simple, point-of-care (POC) test [2].
In order to be able to develop, validate, and scale-up diagnostics, a thorough assessment of the context and settings of use at the different points of care is necessary. This requires research approaches that are able to take into account processes and reveal complex relationships and patterns involved in making diagnostics work in the real world. Qualitative research approaches are ideally suited for this. They offer a range of methodologies, such as in-depth interviews, focus group discussions, participant observations and discourse analysis, that can make sense of processes and meanings in their natural settings, and answer the how and why questions [3].
Yet, qualitative research on TB diagnostics is scarce. The few published studies have mainly focused on how stigma and disease perceptions influence healthcare seeking and diagnosis [4,5], reasons for delay in healthcare seeking [5–7] and what it means to live with TB diagnosis [8]. Such studies generate important insights for test developers, and more research is needed into patient needs and pathways to diagnosis. Yet, it does not make use of the full potential of qualitative research for answering the most pressing questions of the TB diagnostics community.
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