Barriers and Facilitators to Contact Tracing and Investigation of Tuberculosis in Anlemo District, Hadiya Zone, Southern Ethiopia: Qualitative Approach

Abstract

Background: Tuberculosis causes ill health among millions of people each year which is the second leading cause of death from an infectious disease in the world wide. Intensifying TB screening and contact investigation strategy is recommended to ensure early diagnosis approaches in high-risk groups and house hold contacts of TB patients. Objectives: exploring barriers to and facilitators for contact tracing and investigation of TB in Anlemo district, Hadiya zone, Southern Ethiopia. Methods: A descriptive qualitative study was employed from March 12-April 9, 2019. Purposive sampling technique were used to recruit study participants. A total of 16 participants were involved in the study including the health extension workers, index TB patient, house hold contacts of TB patients and district TB coordinator. Data were collected through in depth interviews using semi-structured interview guide. Data were transcribed verbatim, translated and thematic analysis was employed. ATLAS.ti7 computer software was used to manage data. The findings were presented on major themes, categories and quotations. Result: This study explored different barriers and facilitators for contact tracing and contact investigation of TB under the following themes: 1) health system related theme with categories like monitoring and supervision, training of health workers, logistics and infrastructure, waiting time and institutional readiness, referral, feedback and linkage, human resource, charge for some laboratory, and transportation and budget; 2) health worker related theme with categories like Knowledge and awareness, Commitment and motivation, and Work load; 3) Index case and house hold contact related were Knowledge and awareness, workload, commitment and motivation and 4) Socio -economic and cultural related were distance, social support, economic constrain , and stigma and discrimination. Conclusion and Recommendation: Findings suggest that health system related, health worker related, index case and house hold contacts related, and socio-economic and cultural barriers and facilitators work together to hinder and promote contact tracing and investigation of TB. Continuous monitoring and strengthening supportive supervision should be done to improve contact tracing and investigation of TB.