TB Risk Perceptions among Medical Residents at a Tertiary Care Center in India.

SETTING: Government tertiary health care center in India. OBJECTIVE: To understand the perceptions of medical residents about their risk of developing TB in the workplace. DESIGN: Cross-sectional study in which a semistructured questionnaire which included an open-ended question to assess their main concerns regarding TB in workplace was used to collect data. RESULTS: Out of 305 resident doctors approached, 263 (94%) completed a structured questionnaire and 200 of these responded to an open-ended question. Daily exposure to TB was reported by 141 (64%) residents, 13 (5%) reported a prior history of TB, and 175 (69%) respondents were aware of TB infection control guidelines. A majority reported concerns about acquiring TB (78%) and drug-resistant TB (88%). The key themes identified were concerns about developing drug-resistant TB (n = 100; 50%); disease and its clinical consequences (n = 39; 20%); social and professional consequences (n = 37; 19%); exposure to TB patients (n = 32; 16%); poor infection control measures (n = 27; 14%); and high workload and its health consequences (n = 16; 8%). CONCLUSION: Though many resident doctors were aware of TB infection control guidelines, only few expressed concern about lack of TB infection control measures. Doctors need to be convinced of the importance of these measures which should be implemented urgently.

Photovoice: a novel approach to improving antituberculosis treatment adherence in pune, India.

We compared antituberculosis treatment (ATT) adherence and outcomes among patients exposed to Photovoice (video of previously cured TB patients sharing experiences about TB treatment) versus those not exposed. The odds of successful outcome (i.e., cured or completing treatment) for the 135 patients who watched Photovoice were 3 times greater (odds ratio: 2.8; 95% CI: 1.3-6.1) than for patients who did not watch Photovoice. The comparison group, on average, missed more doses (10.9 doses; 95% CI: 6.6-11.1) than the intervention group who saw Photovoice (5.5 doses; 95% CI: 3.7-6.1). Using Photovoice at initiation of ATT has the potential to improve treatment adherence and outcomes.