Factors Associated with the Non-Adherence of TB Screening in Children Aged <15 Years with Smear-Positive TB Patients’ Close Contact

Lidwina Vania Shaynaputri, Anindita Soetadji, D. Adespin, Stefani Candra Firmanti
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Abstract

Background: TB screening in children having close contact with smear-positive TB patients is urgent to conduct to improve the case detection rate and to achieve the “End TB” target. In fact, the implementation of screening in Indonesia is still inadequate.Objective: To analyze the factors associated with the non-adherence of TB screening in children aged <15 years with smear-positive TB patients’ close contact.Methods: A cross-sectional study was conducted in Semarang between February and August 2020. Subjects were children <15 years old with smear-positive TB patient's close contact. Data were collected from interviewed parents or guardians of the child using a structured questionnaire. Chi-square or Fisher's exact test analysis was used to identify the factor associated with non-adherence to TB screening in children.Results: A total of 84 children were recruited into this study. The proportion of children who did not undergo the screening is still high (86,9%), and there was a significant association with children's age (OR 13,556, 95% CI=3.135-58,613), parents' age (OR 41,143, 95% CI=4,025-420,604), parents’ education level (OR 0,114, 95%CI=0.027–0.477), distance to health facilities, knowledge level, perceived barriers, and cues to action. There was no significant association between children’s gender, economic level, perceived threats with non-adherence of screening.Conclusion: Children and parents’ age, education level, distance to health facilities, knowledge level, perception of barriers, and cues to action associated with the non-adherence of TB screening in children aged <15 years with smear-positive TB patients’ close contact.
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与密切接触涂阳结核患者的15岁以下儿童结核病筛查不依从性相关的因素
背景:为提高病例检出率,实现“终结结核病”目标,迫切需要对与涂阳结核患者密切接触的儿童进行结核病筛查。事实上,筛查在印尼的实施仍然不足。目的:分析与涂阳结核患者密切接触的<15岁儿童结核病筛查不依从的相关因素。方法:2020年2月至8月在三宝垄进行横断面研究。研究对象为与涂阳结核患者密切接触的<15岁儿童。数据通过结构化问卷从受访的父母或儿童监护人处收集。使用卡方检验或Fisher精确检验分析来确定与儿童不坚持结核病筛查相关的因素。结果:本研究共招募了84名儿童。未接受筛查的儿童比例仍然很高(86.9%),并且与儿童的年龄(OR 13,556, 95%CI= 3.135-58,613)、父母的年龄(OR 41,143, 95%CI= 4,025-420,604)、父母的教育水平(OR 0,114, 95%CI= 0.027-0.477)、与卫生设施的距离、知识水平、感知障碍和行动线索存在显著关联。儿童的性别、经济水平、感知到的威胁与不遵守筛查之间没有显著的关联。结论:儿童和家长的年龄、受教育程度、与卫生机构的距离、知识水平、对障碍的认知和行动线索与与涂阳结核病患者密切接触的<15岁儿童不坚持结核病筛查有关。
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