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Acceptability of decentralizing childhood tuberculosis diagnosis in low-income countries with high tuberculosis incidence: Experiences and perceptions from health care workers in Sub-Saharan Africa and South-East Asia

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorJOSHI, Basant
dc.contributor.authorDE LIMA, Yara Voss
dc.contributor.authorMASSOM, Douglas Mbang
dc.contributor.authorKAING, Sanary
dc.contributor.authorBANGA, Marie-France
dc.contributor.authorKAMARA, Egerton Tamba
dc.contributor.authorSESAY, Sheriff
dc.contributor.authorBORAND, Laurence
dc.contributor.authorTAGUEBUE, Jean-Voisin
dc.contributor.authorMOH, Raoul
dc.contributor.authorKHOSA, Celso
dc.contributor.authorBRETON, Guillaume
dc.contributor.authorMWANGA-AMUMPAIRE, Juliet
dc.contributor.authorBONNET, Maryline
dc.contributor.authorWOBUDEYA, Eric
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorMARCY, Olivier
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorORNE-GLIEMANN, Joanna
dc.date.accessioned2023-11-27T15:41:36Z
dc.date.available2023-11-27T15:41:36Z
dc.date.issued2023-10-11
dc.identifier.issn2767-3375en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/186175
dc.description.abstractEnDecentralizing childhood tuberculosis services, including diagnosis, is now recommended by the WHO and could contribute to increasing tuberculosis detection in high burden countries. However, implementing microbiological tests and clinical evaluation could be challenging for health care workers (HCWs) in Primary Health Centers (PHCs) and even District Hospitals (DHs). We sought to assess the acceptability of decentralizing a comprehensive childhood tuberculosis diagnosis package from HCWs' perspective. We conducted implementation research nested within the TB-Speed Decentralization study. HCWs from two health districts of Cambodia, Cameroon, Côte d'Ivoire, Mozambique, Sierra Leone, and Uganda implemented systematic screening, nasopharyngeal aspirates (NPA) and stool sample collection with molecular testing, clinical evaluation and chest X-ray (CXR) interpretation. We investigated their experiences and perceptions in delivering the diagnostic package components in 2020-21 using individual semi-structured interviews. We conducted thematic analysis, supported by the Theoretical Framework of Acceptability. HCWs (n = 130, 55% female, median age 36 years, 53% nurses, 72% PHC-based) perceived that systematic screening, although increasing workload, was beneficial as it improved childhood tuberculosis awareness. Most HCWs shared satisfaction and confidence in performing NPA, despite procedure duration, need to involve parents/colleagues and discomfort for children. HCWs shared positive attitudes towards stool sample-collection but were frustrated by delayed stool collection associated with cultural practices, transport and distance challenges. Molecular testing, conducted by nurses or laboratory technicians, was perceived as providing quality results, contributing to diagnosis. Clinical evaluation and diagnosis raised self-efficacy issues and need for continuous training and clinical mentoring. HCWs valued CXR, however complained that technical and logistical problems limited access to digital reports. Referral from PHC to DH was experienced as burdensome. HCWs at DH and PHC-levels perceived and experienced decentralized childhood tuberculosis diagnosis as acceptable. Implementation however could be hampered by feasibility issues, and calls for innovative referral mechanisms for patients, samples and CXR.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.title.enAcceptability of decentralizing childhood tuberculosis diagnosis in low-income countries with high tuberculosis incidence: Experiences and perceptions from health care workers in Sub-Saharan Africa and South-East Asia
dc.title.alternativePLOS Glob Public Healthen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1371/journal.pgph.0001525en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed37819919en_US
bordeaux.journalPLOS Global Public Healthen_US
bordeaux.pagee0001525en_US
bordeaux.volume3en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue10en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGSen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
bordeaux.import.sourcepubmed
hal.identifierhal-04310245
hal.version1
hal.date.transferred2023-11-27T15:41:40Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
workflow.import.sourcepubmed
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=PLOS%20Global%20Public%20Health&rft.date=2023-10-11&rft.volume=3&rft.issue=10&rft.spage=e0001525&rft.epage=e0001525&rft.eissn=2767-3375&rft.issn=2767-3375&rft.au=JOSHI,%20Basant&DE%20LIMA,%20Yara%20Voss&MASSOM,%20Douglas%20Mbang&KAING,%20Sanary&BANGA,%20Marie-France&rft.genre=article


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