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1.
BMC Public Health ; 20(1): 1602, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097021

RESUMO

BACKGROUND: Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs, and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands. METHODS: We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016-May 2018). We used a thematic analysis to identify, analyse and report patterns in the data. RESULTS: Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment. CONCLUSION: The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Tuberculose Latente/psicologia , Refugiados/psicologia , Estigma Social , Adolescente , Adulto , Eritreia/etnologia , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Pesquisa Qualitativa , Adulto Jovem
2.
BMC Public Health ; 20(1): 315, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164637

RESUMO

BACKGROUND: In the Netherlands, migrant populations with a high tuberculosis (TB) incidence are an important target group for TB prevention. However, there is a lack of insight in effective community-engaged strategies to reach and motivate these migrants to participate in latent TB infection (LTBI) screening and treatment programs. METHODS: In cocreation with Eritrean key figures and TB staff, we designed and executed six strategies to reach and motivate Eritrean communities to participate in LTBI programs, in five regions in the Netherlands. We registered participation in LTBI education and screening, and LTBI treatment uptake and completion. We used semi-structured group and individual interviews with Eritrean participants, key figures, and TB staff to identify facilitators and barriers. RESULTS: Uptake of LTBI education (13-75%) and consequent screening (10-124%) varied between strategies. LTBI screening uptake > 100% resulted from educated participants motivating others to participate in screening. Two strategies, using face-to-face promotion and targeting smaller groups, were the most successful. The program resulted in high LTBI treatment initiation and completion (both 97%). Reported program barriers included: competing priorities in the target group, perceived good health, poor risk perception, and scepticism towards the program purpose. TB staff perceived the program as useful but demanding in terms of human resources. CONCLUSIONS: Eritrean migrant communities can be successfully reached and motivated for LTBI screening and treatment programs, when sufficient (human) resources are in place and community members, well-connected to and trusted by the community, are engaged in the design and execution of the program.


Assuntos
Serviços de Saúde Comunitária/métodos , Tuberculose Latente/prevenção & controle , Programas de Rastreamento/estatística & dados numéricos , Migrantes/psicologia , Adulto , Participação da Comunidade , Eritreia/etnologia , Feminino , Humanos , Incidência , Tuberculose Latente/epidemiologia , Masculino , Pessoa de Meia-Idade , Motivação , Países Baixos/epidemiologia , Pesquisa Qualitativa , Medição de Risco , Inquéritos e Questionários , Migrantes/estatística & dados numéricos , Tuberculose/epidemiologia , Adulto Jovem
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