In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 8 ( 2023-8-17), p. e0281918-
Abstract:
Evidence on factors contributing to poor treatment outcome and healthcare priorities in vulnerable populations affected by tuberculosis (TB) in urban areas of England other than London is needed to inform setting-specific prevention and care policies. We addressed this knowledge gap in a cohort of TB patients and healthcare providers in Birmingham and Leicester, UK. Methods A mixed-methods study was performed. Logistic regression was used to identify TB patients more likely to have poor treatment outcomes according to clinical and demographic characteristics and social risk factors (SRFs) in a 2013–18 cohort. 25 semi-structured interviews were undertaken in purposely selected individuals (9 patients and 16 healthcare professionals) to glean insights on their healthcare priorities and the factors that contribute to poor treatment outcome. Results The quantitative cohort comprised 2252 patients. Those who were ≥ 55 years of age, foreign-born from Central Europe, East Asia and Sub Saharan Africa and with MDR-TB were more likely to have poor treatment outcomes. According to patients and healthcare professionals, the factors that contribute to vulnerability to develop TB and poor treatment outcomes include poor working and living conditions, inadequate or absent welfare protection, poor primary healthcare responsiveness, treatment duration and side effects. These factors could be addressed by increased networking, partnership and integration between healthcare and social services and better integration between primary and secondary healthcare. Conclusions In both cities, being ≥ 55 years of age, having MDR-TB and being of foreign-birth are predictors of unfavourable treatment outcome. Risk of poor treatment outcome and vulnerability seem to be multidimensional. A better understanding of specific vulnerabilities and how they affect patient care pathway is needed to design adequate support programmes.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0281918
DOI:
10.1371/journal.pone.0281918.g001
DOI:
10.1371/journal.pone.0281918.t001
DOI:
10.1371/journal.pone.0281918.t002
DOI:
10.1371/journal.pone.0281918.t003
DOI:
10.1371/journal.pone.0281918.t004
DOI:
10.1371/journal.pone.0281918.t005
DOI:
10.1371/journal.pone.0281918.s001
DOI:
10.1371/journal.pone.0281918.s002
DOI:
10.1371/journal.pone.0281918.s003
DOI:
10.1371/journal.pone.0281918.s004
DOI:
10.1371/journal.pone.0281918.r001
DOI:
10.1371/journal.pone.0281918.r002
DOI:
10.1371/journal.pone.0281918.r003
DOI:
10.1371/journal.pone.0281918.r004
DOI:
10.1371/journal.pone.0281918.r005
DOI:
10.1371/journal.pone.0281918.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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