Barriers to effective tuberculosis control: a qualitative study.
METHODS
Emilia Romagna region, Italy.


OBJECTIVE
To explore chest and infectious disease physicians' views of barriers to effective tuberculosis (TB) control and possible solutions.


METHODS
A series of nine focus groups including a total of 49 physicians.


RESULTS
Three categories of barriers to effective TB control were identified: 1) uncertainty about appropriate clinical practice in the treatment of specific sub-groups of patients, such as the elderly or immigrants; 2) organisational factors, such as the availability of diagnostic services and of sufficient resources; and 3) multiple barriers to a viable and effective TB control programme in a country with a low prevalence of TB.


CONCLUSIONS
The lack of integration and coordination of health services, as well as the scarcity of dedicated TB nurses, were perceived by the participants as crucial barriers to effective TB control. As a result of this study, a regional programme was started with the goals of quantifying the need for TB nurses and developing a better network for required health services. Qualitative studies such as this can be useful in improving TB control in a low-prevalence TB country, to identify problems and increase the participation of key professionals.
Moro
M L
ML
Agenzia Sanitaria Regione Emilia Romagna, Area Rischio Infettivo, Bologna, Italy. mlmoro@regione.emilia-romagna.it
Resi
D
D
Lelli
B
B
Nicoli
A
A
Gagliotti
C
C
Falcone
F
F
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D017598:Efficiency, Organizational; D017144:Focus Groups; D006295:Health Resources / Q000600:supply & distribution*; D006297:Health Services Accessibility; D006801:Humans; D010820:Physicians / Q000523:psychology*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012307:Risk Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*