Wademan Dillon Timothy, Hoddinott Graeme, Kavalieratos Zara, Mlomzale Mfundo, Marthinus Arlene J, Jola Lucia N, Jacobs Stephanie, Mcimeli Khanyisa, Seddon James
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa.
BMJ Open. 2025 May 24;15(5):e094295. doi: 10.1136/bmjopen-2024-094295.
Adolescents' experiences (10-19 years-old) with tuberculosis (TB) remain poorly understood. Descriptions of adolescent TB experiences, particularly how they interact with the health system, are scarce. We aimed to understand adolescents' experiences of TB health services in the Western Cape, South Africa. We focused on how TB services were aided or hindered through interactions with healthcare providers and health system processes.
Teen TB, an observational study in Cape Town, enrolled 50 newly diagnosed adolescents with multidrug-resistant and drug-susceptible TB. A subset of 20 was selected for serial qualitative data collection, with 19 completing all tasks between December 2020 and September 2021. 52 interviews were conducted and thematically analysed using a case descriptive process for experiences across the TB care cascade.
Adolescents criticised the difficulties and delays they encountered in obtaining an accurate TB diagnosis. Initial misdiagnoses and delayed TB diagnoses were reported, despite seeking help from multiple healthcare providers at different facilities. Adolescents questioned whether the financial, social and emotional costs of TB care outweighed the costs of delaying treatment initiation and adherence. Adolescents reported that the treatment regimen, adherence support processes and interactions with the health system posed significant challenges to maintaining adherence. Encouragingly, however, most adolescents reported being well treated and cared for by health workers.
Our study shows that adolescents experience challenges throughout their TB treatment journeys. More adolescent-focused research is needed to tailor treatment and healthcare processes to their needs.
青少年（10至19岁）患结核病的经历仍未得到充分了解。关于青少年结核病经历的描述很少，尤其是他们与卫生系统如何互动的描述。我们旨在了解南非西开普省青少年对结核病医疗服务的经历。我们关注的是结核病服务如何通过与医疗服务提供者和卫生系统流程的互动得到促进或阻碍。
“青少年结核病”是一项在开普敦进行的观察性研究，招募了50名新诊断出的耐多药和药敏结核病青少年。选取了20人的一个子集进行系列定性数据收集，其中19人在2020年12月至2021年9月期间完成了所有任务。进行了52次访谈，并使用病例描述过程对结核病护理级联中的经历进行了主题分析。
青少年批评了他们在获得准确结核病诊断时遇到的困难和延误。尽管在不同机构向多名医疗服务提供者寻求帮助，但仍有初始误诊和结核病诊断延误的报告。青少年质疑结核病护理的经济、社会和情感成本是否超过了延迟开始治疗和坚持治疗的成本。青少年报告说，治疗方案、坚持治疗的支持流程以及与卫生系统的互动对维持治疗依从性构成了重大挑战。然而，令人鼓舞的是，大多数青少年报告说医护人员对他们治疗和照顾得很好。
我们的研究表明，青少年在整个结核病治疗过程中都面临挑战。需要开展更多以青少年为重点的研究，以便根据他们的需求调整治疗和医疗流程。
