Effect of COVID-19 on paediatric TB service delivery and patients' comfort receiving TB services in Cameroon and Kenya during COVID: a qualitative assessment.

IF 3.6 3区 医学 Q1 RESPIRATORY SYSTEM
Muhamed Awolu Mbunka, Leila Katirayi, Samantha McCormick, James Ndimbii, Rose Masaba, Lise Denoeud-Ndam, Saint-Just Petnga, Millicent Ouma, Albert Kuate, Gordon Okomo, Leonie Simo, Donald Yara, Appolinaire Tiam, Boris Tchounga
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引用次数: 0

Abstract

Background: The outbreak of COVID-19 has caused a setback to the gains achieved in tuberculosis (TB) control by impairing TB diagnosis, delaying treatment initiation and aggravating TB deaths. This study explored the effect of COVID-19 on paediatric TB services provided through the Catalysing Paediatric TB Innovations (CaP-TB) project among caregivers of children receiving TB services and healthcare workers (HCWs) providing TB services in Cameroon and Kenya.

Methods: From March to September 2021, in-depth interviews (44) were conducted with caregivers whose children under 5 years had gone through TB services and programme managers (10) overseeing the CaP-TB project. Focus group discussions were conducted with HCWs (07) and community health workers (04) supporting TB care services. Transcripts were coded and analysed by using MAXQDA V.12.

Results: The COVID-19 pandemic has caused fear and anxiety among HCWs and caregivers. This fear was motivated by stigma related to COVID-19 and affected the ability to screen patients for TB due to the similarity of symptoms with COVID-19. The health-seeking behaviour of patients was affected, as many caregivers avoided hospitals and those accessing the facilities concealed their sickness due to fear of testing positive or being vaccinated. In addition, COVID-19 mitigation strategies implemented by both government and health facilities to curb the spread of the virus limited patient access to paediatric healthcare services. These included temporary closure of health facilities due to COVID-19 infections among staff, transfer of services to other spaces, spacing out patient appointments and reduced time spent with patients.

Conclusions: The outbreak of COVID-19 has induced fear and stigma that affected patients' health-seeking behaviour and provider attitudes towards paediatric TB service delivery. In addition, facility and governmental measures put in place to mitigate COVID-19 impact negatively affected paediatric service delivery. Training for health personnel, timely provision of personal protective equipments and appropriate communication strategies could help mitigate COVID-19 impact on paediatric TB service delivery.

COVID-19 对喀麦隆和肯尼亚在 COVID 期间提供儿科结核病服务的影响以及患者接受结核病服务的舒适度:定性评估。
背景:COVID-19 的爆发影响了结核病的诊断、推迟了治疗的开始并加剧了结核病死亡,从而使结核病控制方面取得的成果遭受挫折。本研究探讨了 COVID-19 对喀麦隆和肯尼亚通过 "促进儿科结核病创新(CaP-TB)"项目提供的儿科结核病服务的影响:方法:2021 年 3 月至 9 月,对 5 岁以下儿童接受过结核病服务的护理人员和负责 CaP-TB 项目的项目经理(10 人)进行了深入访谈(44 人)。与支持结核病护理服务的医护人员(07 人)和社区医护人员(04 人)进行了焦点小组讨论。使用 MAXQDA V.12 对讨论记录进行了编码和分析:结果:COVID-19 大流行在医护人员中引起了恐惧和焦虑。这种恐惧的动机是与 COVID-19 相关的耻辱感,并且由于症状与 COVID-19 相似而影响了筛查结核病患者的能力。患者的就医行为也受到了影响,因为许多护理人员回避医院,就医者也因害怕检测呈阳性或接种疫苗而隐瞒病情。此外,政府和医疗机构为遏制病毒传播而实施的 COVID-19 缓解策略限制了患者获得儿科医疗服务的机会。这些措施包括:由于工作人员感染了 COVID-19,医疗机构暂时关闭;将服务转移到其他场所;分散病人预约时间;减少与病人的接触时间:结论:COVID-19 的爆发引发了恐惧和耻辱感,影响了患者的就医行为和医疗服务提供者对儿科结核病服务的态度。此外,医疗机构和政府为减轻 COVID-19 的影响而采取的措施也对儿科服务的提供产生了负面影响。对医务人员进行培训、及时提供个人防护设备和适当的沟通策略有助于减轻 COVID-19 对儿科结核病服务的影响。
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来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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