Barriers and enablers of TB infection screening and treatment programme for recent migrants in East London

BACKGROUND: The majority of active TB cases in low-burden, high-income settings arise from reactivation of TB infection (TBI). The London Borough of Newham, UK, piloted a novel screening and treatment TBI programme for recent migrants. This was situated entirely within primary care. OBJECTIVE AND DESIGN: This study aims to highlight key enablers and barriers to delivering a TBI programme in primary care. Views of health care professionals and relevant stakeholders were sought through questionnaires and semi-structured interviews.
RESULTS: Perspectives from 43 health care professionals are included. A perceived 'good relationship' between patients and health care professionals was the most commonly cited enablers across groups, followed by education and training of service providers. Physicians reported time constraints as a common barrier, whereas pharmacists were more likely to identify low levels of patient knowledge surrounding TBI as a barrier to engagement. Enablers identified by stakeholders included effective communication between stakeholders and training of service providers. Aggregate data collection and monitoring was considered a significant enabler, as was patient education by health care professionals and novel educational tools.
CONCLUSION: Community-based TBI programmes can be successful. Key enablers include TBI-specific training with communities and amongst health care professionals, collaboration between health care professionals and stakeholders, and aggregate data monitoring.