Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 18;19(1):233.
doi: 10.1186/s12913-019-4050-0.

Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers

Ana Maria Tavares  1 , Ana Cristina Garcia  2   3 , Ana Gama  4 , Ana B Abecasis  2 , Miguel Viveiros  2 , Sónia Dias  2   4
Affiliations

Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers

Ana Maria Tavares et al. BMC Health Serv Res. .

Abstract

Background: Tuberculosis (TB) is still a major global health problem. The increasing number of cases observed among foreign-born populations contrasts with the decreasing trends observed in later years in some high-income countries. Healthcare providers are key interveners in the control of TB and HIV-TB infections. In this study, we aimed to explore the perspectives of healthcare providers working in primary care in Portugal about the provision of TB care for migrant patients with TB or HIV-TB co-infection.

Methods: We applied a mixed-methods approach using an online survey and semi-structured interviews with primary healthcare providers. A total of 120 Portuguese healthcare providers participated in the survey, and 17 were interviewed. Survey and interview data were analysed applying descriptive statistics and thematic analysis, respectively.

Results: Migrants' lack of knowledge on TB disease and its symptoms was the main reason for advanced-stage presentation of cases. Their high mobility and social isolation affect adherence to treatment. The providers also listed several barriers to migrants' access and use of TB care. The most frequently referred were limited socioeconomic resources, complex bureaucracy at the point of access and registration for healthcare services, especially for undocumented migrants, and obstacles for social protection. Providers also advocated more training initiatives on migrants' health, social and cultural contexts, on HIV and TB integrated care, and on TB scientific update for general practitioners and nurses working at primary healthcare centres.

Conclusions: Future efforts should provide measures to overcome social, economic and administrative obstacles to care for TB-infected migrants, and promote regular training initiatives for national healthcare providers in order to raise awareness and facilitate better care to culturally diverse populations with TB.

Keywords: HIV-TB; Healthcare providers; Migrants; Mixed methods research; Tuberculosis.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Participation was voluntary, informed consent was obtained from all enrolled participants and verbal consent was recorded for each interview. Ethical approval for the online survey was granted from the Ethics Committees for Health of Administração Regional de Saúde de Lisboa e Vale do Tejo (ARSLVT), of Norte (ARSNorte), of Alentejo (ARSAlentejo), and Centro (ARS Centro). Ethical approval for the semi-structured interviews was granted by the Ethics Committee for Health of ARSLVT.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Perceived barriers for migrant patients to access and use of TB care
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization (WHO). Global tuberculosis report 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0. IGO. http://www.who.int/tb/publications/global_report/en. Accessed 22 Oct 2018.
    1. Pareek M, Greenaway C, Noori T, Munoz J, Zenner D. The impact of migration on tuberculosis epidemiology and control in high-income countries: a review. BMC Med. 2016:1–10. 10.1186/s12916-016-0595-5. - PMC - PubMed
    1. Direção-Geral da Saúde (DGS), Programa Nacional para a Tuberculose . Tuberculose em Portugal: Desafios e Estratégias. 2018.
    1. Direção-Geral da Saúde (DGS). Infeção por VIH, SIDA e Tuberculose em números – 2015. 2015. http://www.pnvihsida.dgs.pt/estudos-e-estatisticas111111/relatorios1/por.... Accessed 14 Feb 2019.
    1. European Centre for Disease Prevention and Control (ECDC), World Health Organization (WHO) Regional office for Europe. Tuberculosis surveillance and monitoring in Europe 2018: 2016 data. Stockholm; 2018. https://ecdc.europa.eu/en/publications-data/tuberculosis-surveillance-an.... Accessed 12 Apr 2018.