title: Health care workers' fears associated with working in multidrug- and or extensively-resistant tuberculosis wards in South Africa.
abstract: METHODS
  Twenty-four drug-resistant tuberculosis (TB) hospitals and wards across all nine provinces of South Africa.
  
  
  OBJECTIVE
  To assess health care workers' (HCWs') fears of working in multidrug-resistant TB (MDR-TB) or extensively drug-resistant TB (XDR-TB) wards.
  
  
  METHODS
  A cross-sectional descriptive study was conducted from June to September 2009 in 24 drug-resistant TB hospitals across South Africa. HCWs completed a self-administered questionnaire, including one open-ended question regarding personal concerns about their fear of contracting MDR- or XDR-TB. Responses were analysed by content analysis.
  
  
  RESULTS
  Among the 24 hospitals, 499 HCWs were surveyed, of whom 363 (73%) responded to the open-ended question: 286 (86%) were nurses, 38 (11%) medical officers and 10 (3%) others. Six major themes regarding fears associated with the personal risk of acquiring drug-resistant TB emerged. These included the fear of 1) developing MDR- and XDR-TB, 2) the treatment course, 3) the financial implications, 4) family concerns, 5) working environment and 6) psychosocial issues.
  
  
  CONCLUSIONS
  These data suggest that the greatest fear of HCWs working in drug-resistant TB wards is contracting MDR- or XDR-TB and infecting others. This fear may negatively impact the provision of quality patient-centred care, and highlights the need for training of HCWs in infection control measures, and specifically on how HCWs can protect themselves and others from developing TB.
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: C
authors.initials: C
authors.lastname: Tudor
authors.affiliation: South African Medical Research Council TB Epidemiology and Intervention Research Unit, Pretoria, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Mphahlele
authors.affiliation: South African Medical Research Council TB Epidemiology and Intervention Research Unit, Pretoria, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Van der Walt
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Farley
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D054908:Extensively Drug-Resistant Tuberculosis / Q000635:transmission*; D005239:Fear; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000592:standards; D011787:Quality of Health Care; D013019:South Africa; D011795:Surveys and Questionnaires; D018088:Tuberculosis, Multidrug-Resistant / Q000635:transmission*; D055815:Young Adult