Non-tuberculous mycobacterial pulmonary disease: Awareness survey of front-desk healthcare workers in Northern Tanzania

Togolani Maya; Erick Komba; Gloria Mensah; Nicholaus Mnyambwa; Basra Doulla; Sayoki Mfinanga; Kennedy Addo; Rudovick Kazwala

doi:10.1371/journal.pgph.0000741

Non-tuberculous mycobacterial pulmonary disease: Awareness survey of front-desk healthcare workers in Northern Tanzania

PLOS Glob Public Health. 2023 Jan 20;3(1):e0000741. doi: 10.1371/journal.pgph.0000741. eCollection 2023.

Authors

Togolani Maya^{1

2}, Erick Komba¹, Gloria Mensah³, Nicholaus Mnyambwa⁴, Basra Doulla², Sayoki Mfinanga⁴, Kennedy Addo³, Rudovick Kazwala¹

Affiliations

¹ Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.
² Central Tuberculosis Reference Laboratory, National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania.
³ Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
⁴ National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, Tanzania.

Abstract

Over the past decade, there have been increasing reports of non-tuberculous mycobacteria (NTM) species being implicated in tuberculosis (TB) treatment failure or misdiagnosed as TB. Inadequate awareness of NTM pulmonary disease among healthcare workers (HCWs) may contribute to a low index of suspicion for patients presenting to their hospitals. In this study, we assessed the awareness of NTM pulmonary disease (NTM-PD) among front desk HCWs in Northern Tanzania. A cross-sectional descriptive survey was carried out among front desk HCWs in four administrative regions of Northern Tanzania. A standardized questionnaire was administered to consented participants from four clusters; clinicians, laboratory scientists, nurses, and pharmacists serving TB patients from Regional and District Health Facilities. Each participant was asked a set of questions, scored and the total score for each participant was determined. An awareness score was used to measure the level of awareness. The average score for all participants was estimated including the 95% confidence interval (CI). The overall awareness score was 24.1%, 95% CI 22.0-26.2%. History of training, experience in TB care, level of health facilities, age group, and setting were found to be statistically associated with the level of awareness of study participants. More than two-thirds (67%) of participants believe that pulmonary NTM and TB are clinically similar and 60% are not aware that AFB Microscopy cannot distinguish between the two. Only 13% of participants could mention at least one risk factor for NTM pulmonary disease. The level of awareness of NTM pulmonary disease was poor among HCWs in the surveyed TB clinics. National TB Programs are advised to include a topic on NTM in various on-job TB training packages for HCWs.

Copyright: © 2023 Maya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This work was funded by the DELTAS Africa Initiative (Afrique One-ASPIRE/DEL-15-008 to TM). Afrique One-ASPIRE is funded by a consortium of donors including the African Academy of Sciences (AAS) Alliance for Accelerating Excellence in Science in Africa (AESA), the New Partnership for Africa’s Development Planning and Coordinating (NEPAD) Agency, the Wellcome Trust (107753/A/15/Z), and the UK government. The sponsors had no involvement in the study design, data collection, or in interpretation of the data, and the views expressed in this piece of research are those of the authors and not necessarily those of Afrique One-ASPIRE.