Katirayi Leila, Masaba Rose, Tchounga Boris, Ndimbii James, Mbunka Muhammed, Ouma Millicent, Olughu Kelia, Siehien Jenna, Petnga Saint Just, Casenghi Martina, Okomo Gordon, Zoung-Kanyi Bissek Anne-Cecile, Tiam Appolinaire, Denoeud-Ndam Lise
Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA.
Research, Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya.
BMJ Public Health. 2024 Jul 2;2(Suppl 1):e001001. doi: 10.1136/bmjph-2024-001001. eCollection 2024 Jul.
Paediatric tuberculosis (TB) is often undiagnosed and under-reported. The Catalysing Paediatric TB (CaP-TB) programme provided integrated and decentralised TB screening and diagnosis services through multiple paediatric care entry points. This qualitative evaluation explores acceptability of the CaP-TB programme and existing knowledge and perceptions of paediatric TB.
A descriptive qualitative study was conducted in four sites in Kenya and six sites in Cameron. 54 in-depth interviews were conducted with caregivers, community workers (CWs) and CaP-TB programme managers, and 7 focus group discussions with healthcare workers (HCWs) and CWs. Thematic analysis identified emerging recurrent themes across participants' responses. Data were coded by using MAXQDA V.12. Data were collected during March-September 2021.
Caregivers were often not aware that children were at risk for TB. HCWs reported limited knowledge about paediatric TB prior to CaP-TB. Sometimes caregivers refused to have their children tested for paediatric TB, and this was often related to a lack of awareness of paediatric TB and free services, concerns about the testing procedure and treatment and fear of stigma. TB was referred to as disease of 'shame,' associated with poverty and poor hygiene. The CaP-TB programme increased HCWs knowledge about symptoms of paediatric TB and motivation to investigate children with clinical presentations consistent with possible TB. Adding screening at all entry points was perceived to be beneficial to caregivers who would not have felt comfortable bringing their child to a TB unit. HCWs also discussed the increased workload with CaP-TB, challenges with medication stock-outs and a need for additional training.
CaP-TB illustrated the positive impact of decentralised paediatric TB services, including addressing the awareness and knowledge gap among caregivers and HCWs. Multiple entry points increased opportunities for identification of paediatric TB and increased caregiver comfortability with their child being tested for TB.
NCT03862261.
儿童结核病往往未被诊断出来且报告不足。儿童结核病促进（CaP-TB）项目通过多个儿童护理切入点提供综合且分散的结核病筛查和诊断服务。本定性评估探讨了CaP-TB项目的可接受性以及对儿童结核病的现有认识和看法。
在肯尼亚的四个地点和喀麦隆的六个地点进行了一项描述性定性研究。对照顾者、社区工作者（CWs）和CaP-TB项目经理进行了54次深入访谈，并与医护人员（HCWs）和CWs进行了7次焦点小组讨论。主题分析确定了参与者回答中出现的反复出现的主题。使用MAXQDA V.12对数据进行编码。数据收集于2021年3月至9月期间。
照顾者通常不知道儿童有患结核病的风险。医护人员报告称，在CaP-TB项目开展之前，他们对儿童结核病的了解有限。有时，照顾者会拒绝让他们的孩子接受儿童结核病检测，这通常与对儿童结核病和免费服务缺乏认识、对检测程序和治疗的担忧以及对耻辱感有关。结核病被称为“耻辱”疾病，与贫困和卫生条件差有关。CaP-TB项目增加了医护人员对儿童结核病症状的了解，以及对有与可能的结核病相符的临床表现的儿童进行调查的积极性。在所有切入点增加筛查被认为对那些不愿意带孩子去结核病科室的照顾者有益。医护人员还讨论了CaP-TB项目增加的工作量、药品缺货的挑战以及额外培训的需求。
CaP-TB项目说明了分散式儿童结核病服务的积极影响，包括解决照顾者和医护人员之间的认识和知识差距。多个切入点增加了识别儿童结核病的机会，并提高了照顾者对其孩子接受结核病检测的接受度。
NCT03862261。
