|dc.contributor.advisor||Lalloo, Umesh Gangaram. .||
|dc.description||M. Med. University of KwaZulu-Natal, Durban 2011.||en
Tuberculosis in medical doctors in KwaZulu-Natal (South Africa): Personal
experiences and reflections related to their diagnosis and treatment.
The high tuberculosis (TB) incidence and prevalence fuelled by the concomitant
HIV epidemic in South Africa has resulted in a high rate of tuberculosis infection
in health care workers. This is the first study to investigate the experiences and
reflections of doctors who were diagnosed with active TB during their
employment in high TB burden hospitals in KwaZulu-Natal, South Africa.
Consecutive medical doctors working in both the public and private sectors and
who were treated for active tuberculosis between 2007 and 2010 were
contacted to participate in the study. Each participant completed an informed
consent and a validated anonymous self-administered questionnaire. The study
received ethical approval from the University of KwaZulu-Natal.
Forty doctors participated in the study. The mean age of participants was
33.67±10.63 years. The majority were between 21 and 40 years of age (males
(52.5%), and employed in the public sector (95%). Four (10%) had MDR-TB. A
number of participants were referred for costly special investigations which are
not considered to be part of first line care in South Africa. For example, 15
participants (37.5%) underwent chest CAT scans during the diagnostic period.
Eight doctors reported complications following invasive procedures.
Nineteen (47.5%) of the 33 participants (82.5%) who had experienced sideeffects
related to anti-TB drugs had considered defaulting on their treatment
because of the side-effects of these drugs. Many participants expressed
concerns about the uncaring attitudes of senior medical colleagues and hospital
management. The majority of participants had introspected on their illnesses
and experiences and committed themselves to become more caring and
empathic towards their patients in future.
All health care workers and particularly nurses and medical doctors working in
environments with a high burden of infectious diseases such as HIV and TB, are
at increased risk to TB infection. They encounter various personal and
professional problems following contraction of TB infection. These experiences
had impacted in many ways on their professional lives, and some doctors have
since left the medical profession because of these experiences. The risks
associated with TB must be minimised. Much more therefore remains to be
done in the public health care system if these trends are to be reversed; this
includes health policy changes, health system changes and attitudes of medical
colleagues towards medical doctors who become “victims of illnesses acquired
in the course of duty”.||en
|dc.subject||Physicians--Health and hygiene--KwaZulu-Natal.||en
|dc.title||Tuberculosis in medical doctors in KwaZulu-Natal, South Africa : personal experiences and perceptions related to their diagnosis and treatment.||en