Abstract
South Africa has a high burden of drug-resistant tuberculosis (DR-TB), which has a particularly high mortality among healthcare workers. Junior clinicians deliver key DR-TB services and require training in DR-TB management and prevention. This study aimed to investigate graduating medical students’ knowledge, attitudes, and practices relating to DR-TB, including management, infection control measures, and occupational health services. This cross-sectional, questionnaire-based study at the University of Cape Town, South Africa, recruited final year medical students and included 87 participants. The mean DR-TB knowledge score was 4.7 points (95% confidence interval [CI]: 4.42–5.06, maximum score 8 points). Students reported challenges in accessing respiratory protection, with half (47.7%) struggling to find an N95 respirator when needed. DR-TB exposure was reportedly common. Three students reported prior TB disease, approximately half (n = 49, 55.9%) reported personal concern of active DR-TB disease during undergraduate studies, and the majority (n = 80, 91.9%) correctly perceived themselves to be at increased risk compared to the general population. Medical students are currently unprepared for their role in managing DR-TB in South Africa and unprotected against occupational illness during their studies. This should be addressed in undergraduate curricula and in establishing comprehensive occupational health policies. Resilient personal protective equipment (PPE) supply chains, infection control training, and comprehensive occupational health support have relevance to both DR-TB and novel pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Highlights
Infection prevention and control (IPC) strategies in healthcare facilities have been catapulted to the global stage during the novel coronavirus disease 2019 (COVID-19) pandemic
The relevance of infection control training, adequate ventilation of clinical spaces, addressing stigma related to infectious diseases, use of masks as source control, reliable personal protective equipment (PPE) supply chains, and provision of comprehensive occupational health services brought to light by the COVID-19 pandemic have marked the missed opportunities in preparing health systems to respond to existing and novel pandemics
This study aimed to investigate graduating medical students’ knowledge, attitudes, and practices relating to drug-resistant tuberculosis (DR-TB), including DR-TB care, infection control measures, and occupational health services
Summary
Infection prevention and control (IPC) strategies in healthcare facilities have been catapulted to the global stage during the novel coronavirus disease 2019 (COVID-19) pandemic. South Africa has been pioneering a community-based approach to DR-TB care, whereby patients are diagnosed and initiated on appropriate therapy at their primary care clinic or district hospital [6, 7]. This decentralized care structure requires HCWs to have sufficient knowledge and competencies to effectively manage DR-TB, including junior doctors in their initial 3 years of medical practice. Several studies from high DR-TB prevalence countries have reported increasing awareness of personal DR-TB risk among HCWs [16, 17]; few have investigated behavioral responses to perceived risk
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