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Patients' perceptions regarding multidrug-resistant tuberculosis and barriers to seeking care in a priority city in Brazil during COVID-19 pandemic: A qualitative study.
Santos, Felipe Lima Dos; Souza, Ludmilla Leidianne Limirio; Bruce, Alexandre Tadashi Inomata; Crispim, Juliane de Almeida; Arroyo, Luiz Henrique; Ramos, Antônio Carlos Vieira; Berra, Thaís Zamboni; Alves, Yan Mathias; Scholze, Alessandro Rolim; Costa, Fernanda Bruzadelli Paulino da; Martoreli Júnior, José Francisco; Moncaio, Ana Carolina Scarpel; Pinto, Ione Carvalho; Arcêncio, Ricardo Alexandre.
  • Santos FLD; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Souza LLL; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Bruce ATI; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Crispim JA; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Arroyo LH; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Ramos ACV; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Berra TZ; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Alves YM; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Scholze AR; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Costa FBPD; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Martoreli Júnior JF; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Moncaio ACS; Department of Nursing, Federal University of Catalão, Catalão, Goiás, Brazil.
  • Pinto IC; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
  • Arcêncio RA; Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
PLoS One ; 16(4): e0249822, 2021.
Article in English | MEDLINE | ID: covidwho-1195942
ABSTRACT
This study aimed to analyze the discourses of patients who were diagnosed with multidrug-resistant tuberculosis, the perception of why they acquired this health condition and barriers to seeking care in a priority city in Brazil during the COVID-19 pandemic. This was an exploratory qualitative study, which used the theoretical-methodological framework of the Discourse Analysis of French matrix, guided by the Consolidated Criteria for Reporting Qualitative Research. The study was conducted in Ribeirão Preto, São Paulo, Brazil. Seven participants were interviewed who were undergoing treatment at the time of the interview. The analysis of the participants' discourses allowed the emergence of four discursive blocks (1) impact of the social determinants in the development of multidrug-resistant tuberculosis, (2) barriers to seeking care and difficulties accessing health services, (3) perceptions of the side effects and their impact on multidrug-resistant tuberculosis treatment, and (4) tuberculosis and COVID-19 a necessary dialogue. Through discursive formations, these revealed the determinants of multidrug-resistant tuberculosis. Considering the complexity involved in the dynamics of multidrug-resistant tuberculosis, advancing in terms of equity in health, that is, in reducing unjust differences, is a challenge for public policies, especially at the current moment in Brazil, which is of accentuated economic, political and social crisis. The importance of psychosocial stressors and the lack of social support should also be highlighted as intermediary determinants of health. The study has also shown the situation of COVID-19, which consists of an important barrier for patients seeking care. Many patients reported fear, insecurity and worry with regard to returning to medical appointments, which might contribute to the worsening of tuberculosis in the scenario under study.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Acceptance of Health Care / Tuberculosis, Multidrug-Resistant / SARS-CoV-2 / COVID-19 / Health Services Accessibility Type of study: Observational study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: South America / Brazil Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0249822

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Acceptance of Health Care / Tuberculosis, Multidrug-Resistant / SARS-CoV-2 / COVID-19 / Health Services Accessibility Type of study: Observational study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: South America / Brazil Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0249822