Caregiver perspectives on TB case-finding and HIV clinical services for children diagnosed with TB in Tanzania

Caregivers of children with tuberculosis (TB) and HIV play a critical role in seeking healthcare for their children. To assess the perspectives of caregivers of pediatric TB patients, we conducted 76 in-depth interviews at 10 TB clinics in 5 districts of Tanzania in March 2016. We assessed how the c...

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Bibliographic Details
Published in:AIDS care 2020-04, Vol.32 (4), p.495-499
Main Authors: Emerson, Courtney, Ndakidemi, Elizabeth, Ngowi, Bernard, Medley, Amy, Ng'eno, Bernadette, Godwin, Munuo, Ntinginya, Nyanda, Carpenter, Deborah, Kohi, Wanze, Modi, Surbhi
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Caregivers
Caregivers - psychology
Child
Child Health Services - organization & administration
Children
Children & youth
Clinical decision making
Clinical medicine
Decision making
Delivery of Health Care, Integrated
Diagnosis
Diagnostic software
Diagnostic systems
Diagnostic tests
Health care
Health Services Accessibility
Help seeking behavior
HIV
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - transmission
Human immunodeficiency virus
Humans
Interviews as Topic
linkage to care
Mass Screening - organization & administration
Medical diagnosis
Medical personnel
Patient Acceptance of Health Care
Pediatrics
qualitative
Qualitative Research
Recurrent
Sensitization
Tanzania
Tanzania - epidemiology
Tests
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - drug therapy
Tuberculosis - prevention & control
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Summary:Caregivers of children with tuberculosis (TB) and HIV play a critical role in seeking healthcare for their children. To assess the perspectives of caregivers of pediatric TB patients, we conducted 76 in-depth interviews at 10 TB clinics in 5 districts of Tanzania in March 2016. We assessed how the child received their TB diagnosis, the decision-making process around testing the child for HIV, and the process of linking the child to HIV treatment in the event of an HIV diagnosis. Caregivers suspected TB due to cases in their family, or the child being ill and not improving. Most caregivers noted delays before confirmation of a TB diagnosis and having to visit multiple facilities before a diagnosis. Once diagnosed, some caregivers reported challenges administering TB medications due to lack of pediatric formulations. Reasons for accepting HIV testing included recurrent illness and HIV symptoms, history of HIV in the family, and recommendation of the clinical provider. Caregivers described a relatively seamless process for linking their child to HIV treatment, highlighting the success of TB/HIV integration efforts. The multiple clinic visits required prior to TB diagnosis suggests the need for additional training and sensitization of healthcare workers and better TB diagnostic tools.
ISSN:0954-0121
1360-0451
DOI:10.1080/09540121.2019.1668520