Stillson C H, Okatch H, Frasso R, Mazhani L, David T, Arscott-Mills T, Matlhare M, Steenhoff A P
University of Pennsylvania, Philadelphia, USA; Center for Public Health Initiatives and Master of Public Health Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
University of Pennsylvania, Philadelphia, Center for Public Health Initiatives and Master of Public Health Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of Botswana, Gaborone, Botswana.
Int J Tuberc Lung Dis. 2016 Oct;20(10):1314-1319. doi: 10.5588/ijtld.15.0989.
Government-funded public health clinics in and around Gaborone, Botswana.
To explore the challenges faced by care givers of children on treatment for tuberculosis (TB) to inform a more child-friendly approach to Botswana's National TB Programme (NTP) strategy.
Qualitative study using 28 in-depth interviews with care givers of children receiving anti-tuberculosis treatment.
Care givers identified five main challenges: long delays in their child's diagnosis, difficulty attending clinic for daily treatment, difficulty administering TB medications, stock-outs of TB medications leading to treatment interruptions, and inadequate TB education. Care givers prioritized these same five areas to improve the overall management of their child's TB.
Our findings suggest that despite accessing care through an NTP that adheres to World Health Organization guidelines, care givers for children on treatment in Botswana continue to encounter significant challenges. While each of these represents a potential threat to successful treatment, they can be addressed with relatively small systematic and programmatic adjustments. These results will inform the next version of the Botswana NTP guidelines towards a more child- and care giver-centered approach.
博茨瓦纳哈博罗内及其周边由政府资助的公共卫生诊所。
探讨结核病（TB）治疗儿童的照顾者所面临的挑战，为博茨瓦纳国家结核病规划（NTP）战略制定更关爱儿童的方法提供依据。
采用定性研究方法，对28名接受抗结核治疗儿童的照顾者进行深入访谈。
照顾者确定了五个主要挑战：孩子诊断长期延误、难以到诊所接受日常治疗、难以服用结核病药物、结核病药物缺货导致治疗中断以及结核病教育不足。照顾者将这五个方面列为改善孩子结核病整体管理的优先事项。
我们的研究结果表明，尽管通过遵循世界卫生组织指南的国家结核病规划获得了治疗，但博茨瓦纳接受治疗儿童的照顾者仍然面临重大挑战。虽然这些挑战中的每一个都对成功治疗构成潜在威胁，但通过相对较小的系统和方案调整可以解决。这些结果将为博茨瓦纳国家结核病规划指南的下一版提供参考，以采用更以儿童和照顾者为中心的方法。
