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Perceptions and challenges among health care providers about HIV-TB co-infected children- A qualitative study
Snehi Shrestha1, Mubashir Angolkar1, Ashwini Narasannavar1
1Department of Public Health, J. N. Medical College, KLE Academy of Higher Education and Research (KAHER), Belagavi, India.
Insights
Diagnosing and treating co-infected tuberculosis (TB) and human immunodeficiency virus (HIV) in children presents significant challenges for healthcare providers. Addressing these requires more healthcare professionals, community education, and reliable HIV testing kits.
Area of Science:
- Pediatric infectious diseases
- Public health
- Global health
Background:
- Co-infection of human immunodeficiency virus (HIV) and tuberculosis (TB) in children increases risks of mortality, treatment failure, and recurrence.
- India is focusing on improving the detection and management of pediatric HIV-TB cases and integrating TB and HIV care.
Purpose of the Study:
- To investigate healthcare providers' perspectives and challenges in diagnosing and treating tuberculosis in children with HIV-TB co-infection.
Main Methods:
- In-depth interviews were conducted with 14 healthcare providers at ART centers in the Belagavi district.
- The study focused on identifying perceptions and challenges related to pediatric HIV-TB diagnosis and treatment.
Main Results:
- Key challenges include difficulties in obtaining sputum samples for testing (CBNAAT), children's inability to articulate symptoms, and caregivers' inaccurate reporting of signs.
- Other obstacles include the lack of pediatricians at some ART centers, delayed lab reports, difficulties in administering medication to infants, high rates of loss to follow-up, financial constraints, long travel distances, low community awareness, poverty, illiteracy, stigma, and treatment default leading to death.
Conclusions:
- Successful diagnosis and treatment of pediatric HIV-TB co-infection necessitate increased healthcare provider numbers, enhanced community education, and consistent availability of HIV rapid test kits.
Background:
Human immunodeficiency virus - Tuberculosis (HIV-TB) co-infected patients have a greater risk of mortality, treatment failure, and recurrence. The significant morbidity and mortality rates associated with tuberculosis and human immunodeficiency virus infection in children cause concern. India aims to enhance the detection and treatment of HIV-TB cases in children and coordinate TB & HIV care.
Objective:
To explore the perceptions and challenges of health care providers regarding the diagnosis and treatment of Tuberculosis in HIV-TB co-infected children.
Materials And Method:
In-depth interviews among 14 health care providers were conducted in ART centers of 5 talukas of Belagavi district to identify health care providers' perceptions and challenges regarding pediatric HIV-TB diagnosis and treatment. Interviews were conducted after receiving informed consent.
Results:
Challenges during HIV-TB diagnosis and treatment in children: difficult to get sputum sample for CBNAAT and child was unable to complain about symptoms, caregivers were not able to mention the signs/symptoms correctly, unavailability of a pediatrician in few Taluka ART centers, delay in receiving TB lab report, challenging to feed drugs to an infant, higher loss to follow-up, financial problem, distance from centers, low community awareness, poverty and illiteracy, stigma and death due to TB treatment default.
Conclusion:
Efforts such as expanded health care providers, community education, and a constant supply of HIV rapid test kits are required to ensure successful diagnosis and treatment of HIV-TB co-infected children.
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