They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study
Abstract Background Latent tuberculosis (TB) infection has been known as a seedbed for TB disease later in life. The interruption from latent TB infection to TB disease can be done through TB preventive treatment (TPT). In Cambodia, only 40.0% of children under five years old who were the household...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02379-7 |
| _version_ | 1797865683637239808 |
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| author | Yom An Alvin Kuo Jing Teo Chan Yuda Huot Sivanna Tieng Kim Eam Khun Sok Heng Pheng Chhenglay Leng Serongkea Deng Ngak Song Daisuke Nonaka Siyan Yi |
| author_facet | Yom An Alvin Kuo Jing Teo Chan Yuda Huot Sivanna Tieng Kim Eam Khun Sok Heng Pheng Chhenglay Leng Serongkea Deng Ngak Song Daisuke Nonaka Siyan Yi |
| author_sort | Yom An |
| collection | DOAJ |
| description | Abstract Background Latent tuberculosis (TB) infection has been known as a seedbed for TB disease later in life. The interruption from latent TB infection to TB disease can be done through TB preventive treatment (TPT). In Cambodia, only 40.0% of children under five years old who were the household contacts to bacteriologically confirmed TB cases were initiated with TPT in 2021. Scientific studies of context-specific operational challenges in TPT provision and uptake among children are scarce, particularly in high TB-burden countries. This study identified challenges in TPT provision and uptake among children in Cambodia from the perspective of healthcare providers and caregivers. Methods Between October and December 2020, we conducted in-depth interviews with four operational district TB supervisors, four clinicians and four nurses in charge of TB in referral hospitals, four nurses in charge of TB in health centers, and 28 caregivers with children currently or previously on TB treatment or TPT, and those who refused TPT for their eligible children. Data were audio recorded along with field notetaking. After verbatim transcription, data analyses were performed using a thematic approach. Results The mean age of healthcare providers and caregivers were 40.19 years (SD 12.0) and 47.9 years (SD 14.6), respectively. Most healthcare providers (93.8%) were male, and 75.0% of caregivers were female. More than one-fourth of caregivers were grandparents, and 25.0% had no formal education. Identified key barriers to TPT implementation among children included TPT side effects, poor adherence to TPT, poor understanding of TPT among caregivers, TPT risk perception among caregivers, TPT’s child-unfriendly formula, TPT supply-chain issues, caregivers’ concern about the effectiveness of TPT, being non-parental caregivers, and poor community engagement. Conclusion Findings from this study suggest that the national TB program should provide more TPT training to healthcare providers and strengthen supply chain mechanisms to ensure adequate TPT drug supplies. Improving community awareness of TPT among caregivers should also be intensified. These context-specific interventions will play a crucial role in expanding the TPT program to interrupt the development from latent TB infection to active and ultimately lead to ending TB in the country. |
| first_indexed | 2024-04-09T23:12:06Z |
| format | Article |
| id | doaj.art-94438d682c4c4fd2a60eb223fe010b93 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-09T23:12:06Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-94438d682c4c4fd2a60eb223fe010b932023-03-22T10:19:01ZengBMCBMC Pulmonary Medicine1471-24662023-03-012311810.1186/s12890-023-02379-7They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative studyYom An0Alvin Kuo Jing Teo1Chan Yuda Huot2Sivanna Tieng3Kim Eam Khun4Sok Heng Pheng5Chhenglay Leng6Serongkea Deng7Ngak Song8Daisuke Nonaka9Siyan Yi10Sustaining Technical and Analytical Resources (STAR), the Public Health Institute (PHI)Saw Swee Hock School of Public Health, National University of Singapore and National University Health SystemNational Center for Tuberculosis and Leprosy ControlNational Center for Tuberculosis and Leprosy ControlSchool of Public Health, National Institute of Public HealthNational Center for Tuberculosis and Leprosy ControlNational Center for Tuberculosis and Leprosy ControlWorld Health OrganizationUnited States Agency for International DevelopmentSchool of Health Sciences, Faculty of Medicine, University of the RyukyusSchool of Public Health, National Institute of Public HealthAbstract Background Latent tuberculosis (TB) infection has been known as a seedbed for TB disease later in life. The interruption from latent TB infection to TB disease can be done through TB preventive treatment (TPT). In Cambodia, only 40.0% of children under five years old who were the household contacts to bacteriologically confirmed TB cases were initiated with TPT in 2021. Scientific studies of context-specific operational challenges in TPT provision and uptake among children are scarce, particularly in high TB-burden countries. This study identified challenges in TPT provision and uptake among children in Cambodia from the perspective of healthcare providers and caregivers. Methods Between October and December 2020, we conducted in-depth interviews with four operational district TB supervisors, four clinicians and four nurses in charge of TB in referral hospitals, four nurses in charge of TB in health centers, and 28 caregivers with children currently or previously on TB treatment or TPT, and those who refused TPT for their eligible children. Data were audio recorded along with field notetaking. After verbatim transcription, data analyses were performed using a thematic approach. Results The mean age of healthcare providers and caregivers were 40.19 years (SD 12.0) and 47.9 years (SD 14.6), respectively. Most healthcare providers (93.8%) were male, and 75.0% of caregivers were female. More than one-fourth of caregivers were grandparents, and 25.0% had no formal education. Identified key barriers to TPT implementation among children included TPT side effects, poor adherence to TPT, poor understanding of TPT among caregivers, TPT risk perception among caregivers, TPT’s child-unfriendly formula, TPT supply-chain issues, caregivers’ concern about the effectiveness of TPT, being non-parental caregivers, and poor community engagement. Conclusion Findings from this study suggest that the national TB program should provide more TPT training to healthcare providers and strengthen supply chain mechanisms to ensure adequate TPT drug supplies. Improving community awareness of TPT among caregivers should also be intensified. These context-specific interventions will play a crucial role in expanding the TPT program to interrupt the development from latent TB infection to active and ultimately lead to ending TB in the country.https://doi.org/10.1186/s12890-023-02379-7Preventive treatmentChildhood tuberculosisHealthcare providersCaregiversCambodia |
| spellingShingle | Yom An Alvin Kuo Jing Teo Chan Yuda Huot Sivanna Tieng Kim Eam Khun Sok Heng Pheng Chhenglay Leng Serongkea Deng Ngak Song Daisuke Nonaka Siyan Yi They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study BMC Pulmonary Medicine Preventive treatment Childhood tuberculosis Healthcare providers Caregivers Cambodia |
| title | They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study |
| title_full | They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study |
| title_fullStr | They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study |
| title_full_unstemmed | They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study |
| title_short | They do not have symptoms – why do they need to take medicines? Challenges in tuberculosis preventive treatment among children in Cambodia: a qualitative study |
| title_sort | they do not have symptoms why do they need to take medicines challenges in tuberculosis preventive treatment among children in cambodia a qualitative study |
| topic | Preventive treatment Childhood tuberculosis Healthcare providers Caregivers Cambodia |
| url | https://doi.org/10.1186/s12890-023-02379-7 |
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