Perceptions of Adolescents and Health Workers Towards Adolescents' TB Diagnosis in Central Uganda: A Cross-Sectional Qualitative Study.

adolescent TB adolescent friendly TB services adolescent health school schedules

Journal

Risk management and healthcare policy
ISSN: 1179-1594
Titre abrégé: Risk Manag Healthc Policy
Pays: England
ID NLM: 101566264

Informations de publication

Date de publication:
2021
Historique:
received: 18 09 2021
accepted: 16 11 2021
entrez: 8 12 2021
pubmed: 9 12 2021
medline: 9 12 2021
Statut: epublish

Résumé

Prompt diagnosis of TB among adolescents may reduce transmission and improve individual outcomes. However, TB diagnosis in adolescents is challenging. This study sought to understand challenges to adolescent TB diagnosis. We conducted qualitative focus group discussions (FGDs) to explore adolescents' and health workers' perspectives on challenges to TB diagnosis among adolescents seeking care at four secondary health care facilities in Uganda. Eight FGDs were conducted: four with 32 adolescents consulting for medical care and four with 34 health workers involved in TB care. Adolescents were aware of TB and associated risk factors and believed behaviours like smoking and alcohol use are risk factors for TB. They reported school schedules limit them from seeking TB care and have to miss school or wait for holidays to seek TB diagnosis. They noted school nurses do not take much interest in diagnosing TB and do not refer them to hospitals for further evaluation when they present with TB symptoms. Furthermore, adolescents reported cross-cutting issues like loss of trust in public health systems, encountering unfriendly, judgmental and uncooperative health workers. Health workers mentioned the school environment exposes adolescents to TB as the dormitories they sleep in are overcrowded. They indicated that it was difficult to make a diagnosis of TB in adolescents as the adolescents do not disclose health information. They reported fellow health workers perceive adolescents as being at low risk of TB as they believe most often adolescents are HIV negative and thus have reduced risk of TB. Adolescents present unique challenges that need to be addressed if TB diagnosis is to improve. These challenges could be handled by interventions that lead to minimal disruptions on school schedules, provision of adolescent-friendly services and intervention to build capacity of health care workers in the provision of adolescent-friendly services.

Identifiants

pubmed: 34876864
doi: 10.2147/RMHP.S340112
pii: 340112
pmc: PMC8643211
doi:

Types de publication

Journal Article

Langues

eng

Pagination

4823-4832

Informations de copyright

© 2021 Muttamba et al.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest in this work.

Références

BMC Health Serv Res. 2021 Apr 17;21(1):359
pubmed: 33865395
Lancet. 2012 Apr 28;379(9826):1630-40
pubmed: 22538178
World J Clin Pediatr. 2013 Nov 08;2(4):70-6
pubmed: 25254177
Pediatr Infect Dis J. 2017 Jun;36(6):616-618
pubmed: 28030525
S Afr Med J. 1996 Mar;86(3):231-3
pubmed: 8658287
BMC Infect Dis. 2014 Dec 10;14:638
pubmed: 25492725
BMC Health Serv Res. 2018 Oct 22;18(1):809
pubmed: 30348166
PLoS One. 2021 Jun 7;16(6):e0252808
pubmed: 34097715
Pediatr Infect Dis J. 2019 Oct;38(10):999-1004
pubmed: 31568138
Pediatr Infect Dis J. 2006 Oct;25(10):930-2
pubmed: 17006289
Syst Rev. 2019 Feb 26;8(1):64
pubmed: 30808419
AIDS Care. 2000 Feb;12(1):59-63
pubmed: 10716018
J Int AIDS Soc. 2021 Mar;24(3):e25671
pubmed: 33719199

Auteurs

Winters Muttamba (W)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

Mudarshiru Bbuye (M)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

Joseph Baruch Baluku (J)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Medicine, Mulago National Referral Hospital, Kampala, Uganda.

Stephen Kyaligonza (S)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

Joanitah Nalunjogi (J)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

Ivan Kimuli (I)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

Bruce Kirenga (B)

Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Division of Pulmonary Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

Classifications MeSH