Factors Affecting Motivation among Key Populations to Engage with Tuberculosis Screening and Testing Services in Northwest Tanzania: A Mixed-Methods Analysis

Abstract

In northwest Tanzania, many artisanal small-scale miners (ASMs) and female sex workers (FSWs) live in informal communities surrounding mines where tuberculosis (TB) is highly prevalent. An active case finding (ACF) intervention to increase TB case notification was undertaken in two districts. Alongside this, a study was implemented to understand engagement with the intervention through: (1) quantitative questionnaires to 128 ASMs and FSWs, who either engaged or did not engage in the ACF intervention, to assess their views on TB; (2) qualitative interviews with 41 ASMs and FSWs, 36 community health workers (CHWs) and 30 community stakeholders. The mean perceived severity of TB score was higher in the engaged than in the non-engaged group (p = 0.01). Thematic analysis showed that health-seeking behaviour was similar across both groups but that individuals in the non-engaged group were more reluctant to give sputum samples, often because they did not understand the purpose. CHWs feared contracting TB on the job, and many noted that mining areas were difficult to access without transportation. Community stakeholders provided various recommendations to increase engagement. This study highlights reasons for engagement with a large-scale ACF intervention targeting key populations and presents insights from implementers and stakeholders on the implementation of the intervention.

Knowledge, Attitudes, and Practices of Artisanal and Small-Scale Miners regarding Tuberculosis, Human Immunodeficiency Virus, and Silicosis in Zimbabwe

“…For a long time, artisanal miners have been blamed for their seemingly poor healthseeking behaviour [12,43]. Contrary to this view, a growing body of evidence from southern Africa shows that this is not the case [38,44,45]. Our findings are consistent with this growing body of evidence as we observed that almost all ASMs are keen on having regular screenings for HIV, TB, and silicosis, while those who get sick are willing to seek medical care.…”

Potential of Photon-Counting Detector CT for Radiation Dose Reduction for the Assessment of Interstitial Lung Disease in Patients With Systemic Sclerosis

“…Recent studies demonstrated that ionizing radiation led to increased DNA damage and chromosome aberrations after standard dose chest CT, whereas no such effect was observed for low-dose CT. 11 Therefore, various approaches have been examined for the reduction of radiation dose without a loss in diagnostic accuracy. Among other efforts, reduced slice imaging, 5 low radiation dose imaging, 12 and the use of magnetic resonance imaging 13,14 have been evaluated for the assessment of lung parenchyma alterations in SSc patients. So far, these efforts have been accompanied by a loss of accuracy.…”

“…Therefore, various approaches have been examined for the reduction of radiation dose without a loss in diagnostic accuracy. Among other efforts, reduced slice imaging, 5 low radiation dose imaging, 12 and the use of magnetic resonance imaging 13,14 have been evaluated for the assessment of lung parenchyma alterations in SSc patients. So far, these efforts have been accompanied by a loss of accuracy 15 .…”