Research, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon.
Research, Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA.
BMJ Open Respir Res. 2024 Jul 29;11(1):e001727. doi: 10.1136/bmjresp-2023-001727.
The outbreak of COVID-19 has caused a setback to the gains achieved in tuberculosis (TB) control by impairing TB diagnosis, delaying treatment initiation and aggravating TB deaths. This study explored the effect of COVID-19 on paediatric TB services provided through the Catalysing Paediatric TB Innovations (CaP-TB) project among caregivers of children receiving TB services and healthcare workers (HCWs) providing TB services in Cameroon and Kenya.
From March to September 2021, in-depth interviews (44) were conducted with caregivers whose children under 5 years had gone through TB services and programme managers (10) overseeing the CaP-TB project. Focus group discussions were conducted with HCWs (07) and community health workers (04) supporting TB care services. Transcripts were coded and analysed by using MAXQDA V.12.
The COVID-19 pandemic has caused fear and anxiety among HCWs and caregivers. This fear was motivated by stigma related to COVID-19 and affected the ability to screen patients for TB due to the similarity of symptoms with COVID-19. The health-seeking behaviour of patients was affected, as many caregivers avoided hospitals and those accessing the facilities concealed their sickness due to fear of testing positive or being vaccinated. In addition, COVID-19 mitigation strategies implemented by both government and health facilities to curb the spread of the virus limited patient access to paediatric healthcare services. These included temporary closure of health facilities due to COVID-19 infections among staff, transfer of services to other spaces, spacing out patient appointments and reduced time spent with patients.
The outbreak of COVID-19 has induced fear and stigma that affected patients' health-seeking behaviour and provider attitudes towards paediatric TB service delivery. In addition, facility and governmental measures put in place to mitigate COVID-19 impact negatively affected paediatric service delivery. Training for health personnel, timely provision of personal protective equipments and appropriate communication strategies could help mitigate COVID-19 impact on paediatric TB service delivery.
COVID-19 的爆发损害了结核病（TB）的诊断，延迟了治疗的启动，并加剧了结核病的死亡，这使结核病控制方面取得的进展出现倒退。本研究旨在探讨 COVID-19 对在喀麦隆和肯尼亚通过 Catalysing Paediatric TB Innovations（CaP-TB）项目为接受结核病服务的儿童的照料者和提供结核病服务的卫生保健工作者（HCWs）提供的儿科结核病服务的影响。
2021 年 3 月至 9 月，对接受过 5 岁以下儿童结核病服务的照料者（44 人）和监督 CaP-TB 项目的项目管理人员（10 人）进行了深入访谈。还与 HCWs（07 人）和支持结核病护理服务的社区卫生工作者（04 人）进行了焦点小组讨论。使用 MAXQDA V.12 对转录本进行编码和分析。
COVID-19 大流行引起了 HCWs 和照料者的恐惧和焦虑。这种恐惧是由与 COVID-19 相关的污名引起的，由于 COVID-19 症状与结核病相似，这影响了对患者进行结核病筛查的能力。患者的就医行为受到了影响，因为许多照料者避免去医院，而那些去医院的人则因害怕检测呈阳性或接种疫苗而隐瞒自己的病情。此外，政府和卫生机构为遏制病毒传播而实施的 COVID-19 缓解策略限制了患者获得儿科保健服务的机会。其中包括由于工作人员感染 COVID-19 而临时关闭卫生机构、将服务转移到其他场所、间隔患者预约和减少与患者的接触时间。
COVID-19 的爆发引起了恐惧和污名，这影响了患者的就医行为和提供者提供儿科结核病服务的态度。此外，为缓解 COVID-19 影响而采取的设施和政府措施对儿科服务的提供产生了负面影响。对卫生人员进行培训、及时提供个人防护设备和采取适当的沟通策略有助于减轻 COVID-19 对儿科结核病服务提供的影响。
