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Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study
SETTING: In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged
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| Published in: | The international journal of tuberculosis and lung disease 2017-02, Vol.21 (2), p.154-160 |
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| Main Authors: | , , , , , , , , |
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| Language: | English |
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| container_end_page | 160 |
| container_issue | 2 |
| container_start_page | 154 |
| container_title | The international journal of tuberculosis and lung disease |
| container_volume | 21 |
| creator | Chiang, S. S. Roche, S. Contreras, C. del Castillo, H. Canales, P. Jimenez, J. Tintaya, K. Becerra, M. C. Lecca, L. |
| description | SETTING: In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged |
| doi_str_mv | 10.5588/ijtld.16.0624 |
| format | article |
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S. ; Roche, S. ; Contreras, C. ; del Castillo, H. ; Canales, P. ; Jimenez, J. ; Tintaya, K. ; Becerra, M. C. ; Lecca, L.</creator><creatorcontrib>Chiang, S. S. ; Roche, S. ; Contreras, C. ; del Castillo, H. ; Canales, P. ; Jimenez, J. ; Tintaya, K. ; Becerra, M. C. ; Lecca, L.</creatorcontrib><description>SETTING: In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged <15 years. Peru's TB burden is concentrated in the Lima metropolitan area, particularly in poor districts such as El Agustino and La Victoria, where this study was conducted.OBJECTIVE: To identify barriers to the treatment of childhood tuberculous infection and TB disease in Lima from the perspective of front-line providers and patients' families.DESIGN: We conducted 10 semi-structured focus groups with 53 purposefully sampled primary care providers, community health workers, and parents/guardians of pediatric TB patients. We also completed nine in-depth interviews with National TB Program administrators and pulmonologists specializing in TB. Two authors performed inductive thematic analysis and identified emerging themes.RESULTS: Four main treatment barriers emerged from the data: 1) dosing errors, 2) time- and labor-intensive preparation and administration of medications, 3) provider concern that isoniazid preventive therapy (IPT) generates isoniazid resistance, and 4) poor adherence to IPT.CONCLUSION: Our findings highlight the urgent need for child-friendly formulations, provider and parent/guardian education about IPT, and strategies to promote adherence to IPT, including support and supervision by health workers and/or regimens with fewer doses.</description><identifier>ISSN: 1027-3719</identifier><identifier>EISSN: 1815-7920</identifier><identifier>DOI: 10.5588/ijtld.16.0624</identifier><identifier>PMID: 28234078</identifier><language>eng</language><publisher>France: International Union Against Tuberculosis and Lung Disease</publisher><subject>Adolescent ; Antitubercular Agents - administration & dosage ; Child ; Child, Preschool ; Child-Friendly Formulations ; Community Health Worker ; Community Health Workers ; Drug Resistance, Bacterial ; Female ; Focus Groups ; Humans ; Isoniazid - administration & dosage ; isoniazid preventive therapy ; Latent Tuberculous Infection ; Lima ; Male ; Medication Adherence ; Medication Errors ; Mycobacterium ; National Health Programs ; Parents ; Peru ; Primary Health Care ; Tuberculosis - drug therapy</subject><ispartof>The international journal of tuberculosis and lung disease, 2017-02, Vol.21 (2), p.154-160</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-28d3a6ce8999f34860f66e60396cc54250957f51beb5e17e36130c9239f6c3153</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28234078$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chiang, S. S.</creatorcontrib><creatorcontrib>Roche, S.</creatorcontrib><creatorcontrib>Contreras, C.</creatorcontrib><creatorcontrib>del Castillo, H.</creatorcontrib><creatorcontrib>Canales, P.</creatorcontrib><creatorcontrib>Jimenez, J.</creatorcontrib><creatorcontrib>Tintaya, K.</creatorcontrib><creatorcontrib>Becerra, M. C.</creatorcontrib><creatorcontrib>Lecca, L.</creatorcontrib><title>Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study</title><title>The international journal of tuberculosis and lung disease</title><addtitle>Int J Tuberc Lung Dis</addtitle><description>SETTING: In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged <15 years. Peru's TB burden is concentrated in the Lima metropolitan area, particularly in poor districts such as El Agustino and La Victoria, where this study was conducted.OBJECTIVE: To identify barriers to the treatment of childhood tuberculous infection and TB disease in Lima from the perspective of front-line providers and patients' families.DESIGN: We conducted 10 semi-structured focus groups with 53 purposefully sampled primary care providers, community health workers, and parents/guardians of pediatric TB patients. We also completed nine in-depth interviews with National TB Program administrators and pulmonologists specializing in TB. Two authors performed inductive thematic analysis and identified emerging themes.RESULTS: Four main treatment barriers emerged from the data: 1) dosing errors, 2) time- and labor-intensive preparation and administration of medications, 3) provider concern that isoniazid preventive therapy (IPT) generates isoniazid resistance, and 4) poor adherence to IPT.CONCLUSION: Our findings highlight the urgent need for child-friendly formulations, provider and parent/guardian education about IPT, and strategies to promote adherence to IPT, including support and supervision by health workers and/or regimens with fewer doses.</description><subject>Adolescent</subject><subject>Antitubercular Agents - administration & dosage</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Child-Friendly Formulations</subject><subject>Community Health Worker</subject><subject>Community Health Workers</subject><subject>Drug Resistance, Bacterial</subject><subject>Female</subject><subject>Focus Groups</subject><subject>Humans</subject><subject>Isoniazid - administration & dosage</subject><subject>isoniazid preventive therapy</subject><subject>Latent Tuberculous Infection</subject><subject>Lima</subject><subject>Male</subject><subject>Medication Adherence</subject><subject>Medication Errors</subject><subject>Mycobacterium</subject><subject>National Health Programs</subject><subject>Parents</subject><subject>Peru</subject><subject>Primary Health Care</subject><subject>Tuberculosis - drug therapy</subject><issn>1027-3719</issn><issn>1815-7920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkT1vFDEQhlcIREKgpEUuafbw2GevTQfhU4oEBdQjn3c259PebuKPSMmvx3d7IBok3HikefRo9L5N8xL4Silj3oRdHvsV6BXXYv2oOQcDqu2s4I_rzEXXyg7sWfMspR3nAgC6p82ZMEKueWfOm917F2OgmFieWd4Sy5Fc3tOU2Twwvw1jv53nnuWyoejLOJfEwjSQz2GemJv-2qSQWB8SuURvmWO3xY0huxzuiKVc-vvnzZPBjYlenP6L5uenjz8uv7RX3z5_vXx31fq15rkVppdOezLW2kGujeaD1qS5tNp7tRaKW9UNCja0UQQdSQ2SeyukHbSXoORF83rx3sT5tlDKuA_J0zi6ier5CKYTqrNG8v9AdcWENVDRdkF9nFOKNOBNDHsX7xE4HprAYxMIGg9NVP7VSV02e-r_0L-jr8D3BQjTdY3b4W4ucarBYPAYijvKaoGH_vBOwCRQ1AK5EQpBcYU9Da6MGbOLeP2ASVflh38pF99youDQIT8-AaeBC3QxHwYtfwHLdrZP</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Chiang, S. S.</creator><creator>Roche, S.</creator><creator>Contreras, C.</creator><creator>del Castillo, H.</creator><creator>Canales, P.</creator><creator>Jimenez, J.</creator><creator>Tintaya, K.</creator><creator>Becerra, M. C.</creator><creator>Lecca, L.</creator><general>International Union Against Tuberculosis and Lung Disease</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20170201</creationdate><title>Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study</title><author>Chiang, S. S. ; Roche, S. ; Contreras, C. ; del Castillo, H. ; Canales, P. ; Jimenez, J. ; Tintaya, K. ; Becerra, M. 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S.</au><au>Roche, S.</au><au>Contreras, C.</au><au>del Castillo, H.</au><au>Canales, P.</au><au>Jimenez, J.</au><au>Tintaya, K.</au><au>Becerra, M. C.</au><au>Lecca, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study</atitle><jtitle>The international journal of tuberculosis and lung disease</jtitle><addtitle>Int J Tuberc Lung Dis</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>21</volume><issue>2</issue><spage>154</spage><epage>160</epage><pages>154-160</pages><issn>1027-3719</issn><eissn>1815-7920</eissn><abstract>SETTING: In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged <15 years. Peru's TB burden is concentrated in the Lima metropolitan area, particularly in poor districts such as El Agustino and La Victoria, where this study was conducted.OBJECTIVE: To identify barriers to the treatment of childhood tuberculous infection and TB disease in Lima from the perspective of front-line providers and patients' families.DESIGN: We conducted 10 semi-structured focus groups with 53 purposefully sampled primary care providers, community health workers, and parents/guardians of pediatric TB patients. We also completed nine in-depth interviews with National TB Program administrators and pulmonologists specializing in TB. Two authors performed inductive thematic analysis and identified emerging themes.RESULTS: Four main treatment barriers emerged from the data: 1) dosing errors, 2) time- and labor-intensive preparation and administration of medications, 3) provider concern that isoniazid preventive therapy (IPT) generates isoniazid resistance, and 4) poor adherence to IPT.CONCLUSION: Our findings highlight the urgent need for child-friendly formulations, provider and parent/guardian education about IPT, and strategies to promote adherence to IPT, including support and supervision by health workers and/or regimens with fewer doses.</abstract><cop>France</cop><pub>International Union Against Tuberculosis and Lung Disease</pub><pmid>28234078</pmid><doi>10.5588/ijtld.16.0624</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1027-3719 |
| ispartof | The international journal of tuberculosis and lung disease, 2017-02, Vol.21 (2), p.154-160 |
| issn | 1027-3719 1815-7920 |
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| source | PubMed |
| subjects | Adolescent Antitubercular Agents - administration & dosage Child Child, Preschool Child-Friendly Formulations Community Health Worker Community Health Workers Drug Resistance, Bacterial Female Focus Groups Humans Isoniazid - administration & dosage isoniazid preventive therapy Latent Tuberculous Infection Lima Male Medication Adherence Medication Errors Mycobacterium National Health Programs Parents Peru Primary Health Care Tuberculosis - drug therapy |
| title | Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study |
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