Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jan 12, 2025
Date Accepted: Aug 31, 2025
Perceptions of Occupational Risk and Adherence to Tuberculosis Prevention Among Healthcare Workers: A Scoping Review Protocol
ABSTRACT
Background:
Tuberculosis (TB) remains a major global public health issue, and a particular concern among healthcare staff in the high-risk environment of medical treatment. The HCWs are at the forefront of TB control, consequently the exposed to occupational Mycobacterium tuberculosis exposure. Compared to the general population, healthcare workers (HCWs) are at a higher risk of tuberculosis (TB) infection as the dependent factor of the World Health Organization (WHO) has estimated HCWs to be approximately 2–3 times more likely to become infected with TB. Occupational risk perceptions can be compromised, contributing to nonadherence to proven effective TB prevention regimens (eg, PPE and regular enrolment in health screenings). Though there has been a notable advancement in the treatment of TB, nosocomial or hospital-acquired TB infections remains a considerable occupational risk, particularly with the complex interplay of multidrug-resistant (MDR) TB and HIV/AIDS in clinical settings. Studies showed that HCWs’ TB preventive behaviorwidely differ and is determined by their risk perceptions,knowledge levels, and institutional support. For example, healthcare workers at higher risk of tuberculosis are generally more engaged in following preventive behaviours Yet, persistent barriers remain, such as insufficient PPE, poor ventilation and TB stigma
Objective:
This objective aims to examine and marry the existing body of knowledge about healthcare workers' perceived risks of TB and how these perceptions impact their adherence to any measures for TB prevention. The results of this scoping review will identify gaps in the current literature that should inform policy and practice and guide future research studies to optimise, TB prevention in HCWs
Methods:
This scoping review will be conducted following the framework proposed by Arksey and O’Malley, incorporating recent advancements by Levac et al. This approach involves six key stages: identifying the research question, identifying relevant studies, selecting studies, charting the data, collating, summarizing, and reporting results, and consulting with stakeholders.
Results:
HCWs' risk perceptions significantly influence adherence to TB prevention, including personal protective equipment usage and health screenings. Key barriers include insufficient resources, inadequate training, and TB stigma. The thematic analysis highlighted disparities in adherence based on institutional support and individual awareness levels. Despite progress in TB treatment, nosocomial infections remain a persistent risk, particularly in low- and middle-income countries (LMICs) like Indonesia, where HCWs face a higher incidence of latent TB infection (LTBI).
Conclusions:
This review underscores the critical role of HCWs’ perceptions in shaping TB prevention behaviors. Addressing gaps in institutional support, stigma, and training is essential to enhance adherence. Future interventions should be tailored to specific challenges identified in LMICs, promoting a safer healthcare environment globally. Clinical Trial: none
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