A qualitative exploration of challenges in childhood TB patients identification and diagnosis in Bangladesh
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BRAC James P Grant School of Public Health, Bangladesh
BRAC James P. Grant School of Public Health, Bangladesh
National Tuberculosis Control Programme, Bangladesh
Communicable Diseases, Water, Sanitation, and Hygiene (WASH), Integrated Development, and Humanitarian Crisis Management, BRAC, Bangladesh
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A253
Background and Objective: As childhood TB is difficult to identify and diagnose, the experiences of the caregivers and healthcare providers of childhood TB patients remain a potential area of study. This study aims to illustrate the challenges caregivers and healthcare providers encounter in identifying and diagnosing childhood TB in two sub-districts of Bangladesh. Methods: We conducted semi-structured in-depth interviews with eight caregivers of childhood TB patients and key informant interviews with 36 healthcare providers from July 2019 to June 2020 from different levels of the TB control program in Keraniganj (with high childhood TB cases notification), Faridpur Sadar (with low childhood TB cases notification), and Dhaka city. Results: There is a dearth of understanding among caregivers about childhood TB. Passive case finding process and focus on cough during community mobilisation contribute to delay in childhood TB identification. The stigmatisation that caregivers anticipate and experience has an impact on their mental health and implies that there are misunderstandings about tuberculosis in the community. Furthermore, diagnostic dilemma among healthcare providers accounts for diagnosis delays. Some, but not all, institutions in different geographical locations provide free diagnostic tests and have GeneXpert devices. Conclusions: Awareness should be raised in the community on childhood TB. The identification and diagnosis mechanism of childhood TB should be strengthened to minimise challenges faced by the caregivers and the healthcare providers so that children with TB can have an early identification, diagnosis, treatment initiation, and successful completion of treatment. Overall, addressing the challenges would lead to better case identification and diagnosis.