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Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania

BACKGROUND: Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study e...

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Autores principales: Bjerrum, Stephanie, Rose, Michala V, Bygbjerg, Ib C, Mfinanga, Sayoki G, Tersboel, Britt P, Ravn, Pernille
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275493/
https://www.ncbi.nlm.nih.gov/pubmed/22229965
http://dx.doi.org/10.1186/1472-6963-12-6
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author Bjerrum, Stephanie
Rose, Michala V
Bygbjerg, Ib C
Mfinanga, Sayoki G
Tersboel, Britt P
Ravn, Pernille
author_facet Bjerrum, Stephanie
Rose, Michala V
Bygbjerg, Ib C
Mfinanga, Sayoki G
Tersboel, Britt P
Ravn, Pernille
author_sort Bjerrum, Stephanie
collection PubMed
description BACKGROUND: Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study explored primary health care staff's perception, challenges and needs pertaining to the identification of children with tuberculosis in Muheza district in Tanzania. METHODS: We conducted a qualitative study that included 13 semi-structured interviews and 3 focus group discussions with a total of 29 health staff purposively sampled from primary health care facilities. Analysis was performed in accordance with the principles of a phenomenological analysis. RESULTS: Primary health care staff perceived childhood tuberculosis to be uncommon in the society and tuberculosis was rarely considered as a likely differential diagnosis. Long duration and severe signs of disease together with known exposure to tuberculosis were decisive for the staff to suspect tuberculosis in children and refer them to hospital. None of the staff felt equipped to identify cases of childhood tuberculosis and they experienced lack of knowledge, applicable tools and guidelines as the main challenges. They expressed the need for more training, supervision and referral feedback to improving case identification. CONCLUSIONS: Inadequate awareness of the burden of childhood tuberculosis, limited knowledge of the wide spectrum of clinical presentation and lack of clinical decision support strategies is detrimental to the health staff's central responsibility of suspecting and referring children with tuberculosis especially in the early disease stages. Activities to improve case identification should focus on skills required by primary health care staff to fulfil their responsibility and reflect primary health care level capacities and challenges.
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spelling pubmed-32754932012-02-09 Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania Bjerrum, Stephanie Rose, Michala V Bygbjerg, Ib C Mfinanga, Sayoki G Tersboel, Britt P Ravn, Pernille BMC Health Serv Res Research Article BACKGROUND: Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study explored primary health care staff's perception, challenges and needs pertaining to the identification of children with tuberculosis in Muheza district in Tanzania. METHODS: We conducted a qualitative study that included 13 semi-structured interviews and 3 focus group discussions with a total of 29 health staff purposively sampled from primary health care facilities. Analysis was performed in accordance with the principles of a phenomenological analysis. RESULTS: Primary health care staff perceived childhood tuberculosis to be uncommon in the society and tuberculosis was rarely considered as a likely differential diagnosis. Long duration and severe signs of disease together with known exposure to tuberculosis were decisive for the staff to suspect tuberculosis in children and refer them to hospital. None of the staff felt equipped to identify cases of childhood tuberculosis and they experienced lack of knowledge, applicable tools and guidelines as the main challenges. They expressed the need for more training, supervision and referral feedback to improving case identification. CONCLUSIONS: Inadequate awareness of the burden of childhood tuberculosis, limited knowledge of the wide spectrum of clinical presentation and lack of clinical decision support strategies is detrimental to the health staff's central responsibility of suspecting and referring children with tuberculosis especially in the early disease stages. Activities to improve case identification should focus on skills required by primary health care staff to fulfil their responsibility and reflect primary health care level capacities and challenges. BioMed Central 2012-01-09 /pmc/articles/PMC3275493/ /pubmed/22229965 http://dx.doi.org/10.1186/1472-6963-12-6 Text en Copyright ©2012 Bjerrum et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bjerrum, Stephanie
Rose, Michala V
Bygbjerg, Ib C
Mfinanga, Sayoki G
Tersboel, Britt P
Ravn, Pernille
Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania
title Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania
title_full Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania
title_fullStr Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania
title_full_unstemmed Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania
title_short Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania
title_sort primary health care staff's perceptions of childhood tuberculosis: a qualitative study from tanzania
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275493/
https://www.ncbi.nlm.nih.gov/pubmed/22229965
http://dx.doi.org/10.1186/1472-6963-12-6
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