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When students become patients : TB disease among medical undergraduates in Cape Town, South Africa

dc.contributor.authorVan der Westhuizen, Helene-Marien_ZA
dc.contributor.authorDramowski, Angelaen_ZA
dc.date.accessioned2018-11-28T10:35:19Z
dc.date.available2018-11-28T10:35:19Z
dc.date.issued2017
dc.identifier.citationVan Der Westhuizen, H. M. & Dramowski, A. 2017. When students become patients : TB disease among medical undergraduates in Cape Town, South Africa. South African Medical Journal, 107(6):475-479, doi:10.7196/SAMJ.2017.v107i6.12260
dc.identifier.citation2078-5135 (online)
dc.identifier.citation0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2017.v107i6.12260
dc.identifier.urihttp://hdl.handle.net/10019.1/104743
dc.descriptionCITATION: Van Der Westhuizen, H. M. & Dramowski, A. 2017. When students become patients : TB disease among medical undergraduates in Cape Town, South Africa. South African Medical Journal, 107(6):475-479, doi:10.7196/SAMJ.2017.v107i6.12260.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. Medical students acquire latent tuberculosis (TB) infection at a rate of 23 cases/100 person-years. The frequency and impact of occupational TB disease in this population are unknown. Methods. A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated doctors (2010 - 2015) at two medical schools in Cape Town. Individuals who had developed TB disease as undergraduate students were eligible to participate. Quantitative and qualitative data collected from the questionnaire and semi-structured interviews were analysed with descriptive statistics and a framework approach to identify emerging themes. Results. Twelve individuals (10 female) reported a diagnosis of TB: pulmonary TB (n=6), pleural TB (n=3), TB lymphadenitis (n=2) and TB spine (n=1); 2/12 (17%) had drug-resistant disease (DR-TB). Mean diagnostic delay post consultation was 8.1 weeks, with only 42% of initial diagnoses being correct. Most consulted private healthcare providers (general practitioners (n=7); pulmonologists (n=4)), and nine underwent invasive procedures (bronchoscopy, pleural fluid aspiration and tissue biopsy). Substantial healthcare costs were incurred (mean ZAR25 000 for drug-sensitive TB, up to ZAR104 000 for DR-TB). Students struggled to obtain treatment, incurred high transport costs and missed academic time. Students with DR-TB interrupted their studies and experienced severe side-effects (hepatotoxicity, depression and permanent ototoxicity). Most participants cited poor TB infection-control practices at their training hospitals as a major risk factor for occupational TB. Conclusions. Undergraduate medical students in Cape Town are at high risk of occupationally acquired TB, with an unmet need for comprehensive occupational health services and support.en_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/11917
dc.format.extent5 pages
dc.language.isoen_ZAen_ZA
dc.publisherHealth & Medical Publishing Group
dc.subjectTuberculosis in medical students -- South Africa -- Cape Townen_ZA
dc.subjectMedical students -- Health aspectsen_ZA
dc.subjectOccupational diseasesen_ZA
dc.subjectLatent virus diseasesen_ZA
dc.subjectTuberculosis infection -- Treatmenten_ZA
dc.titleWhen students become patients : TB disease among medical undergraduates in Cape Town, South Africaen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderHealth & Medical Publishing Group


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