Factors Affecting the Integration of Pediatric TB Screening in Kabale District of Uganda: A Cross Sectional Study.

IF 1.7 Q2 PEDIATRICS Pediatric health, medicine and therapeutics Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI:10.2147/PHMT.S471982
Immaculate Mandera, Geoffrey Ayebazibwe, Alex Tumusiime, Topher Byamukama, Valence Mfitumukiza, John Bosco Tamu Munezero, Timothy Nduhukire, Everd B Maniple
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Abstract

Background: Globally, >1.1 million children had tuberculosis (TB) and >214,000 died in 2022. The integration of pediatric TB screening should help in the identification and management of cases among children attending clinics at entry points. This study aimed to establish the extent of integrating pediatric TB screening into mainstream childcare activities and the factors affecting integration of TB screening among children.

Methods: A cross-sectional design using both quantitative and qualitative methods. Simple random sampling was used to select and observe 40 participants for integration of TB screening in the routine assessment of children. Twenty key informants were interviewed and two focus group discussions conducted on the integration of pediatric TB screening.

Results: Of the 302 children assessed, only 41.1% underwent pediatric TB screening integrated in their assessment. A binary logistic regression model using Wald chi-square showed that a cadre having worked at outpatient department (OPD) and young child clinic (YCC) significantly affected integration, with a p-value of 0.002 and 95% CI (1.040-1.152) and a p-value of 0.002 and 95% CI (1.000-1.519). Participants who had 3 to 5 years in service were 7.05 times more likely to integrate pediatric TB screening at the OPD and Cadres who had over 6 years in service were 6.32 times more likely at the YCC. Being a nurse or a midwife was associated with an increased likelihood of integrating pediatric tuberculosis screening. Knowledge, skills, and confidence gaps in screening and assessing for tuberculosis in children among staff and lack of necessary logistics were identified barriers.

Conclusion: The integration of pediatric TB screening in routine assessments at the OPD/YCC was low. Focus more on HC IIIs to improve health workers' involvement and capacity to integrate TB screening at entry points in health facilities and provide logistics.

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影响乌干达卡巴莱地区儿童结核病筛查一体化的因素:一项横断面研究。
背景:2022 年,全球有超过 110 万名儿童患有结核病(TB),超过 21.4 万名儿童死亡。整合儿科结核病筛查应有助于在就诊点识别和管理就诊儿童中的病例。本研究旨在确定将儿童结核病筛查纳入主流儿童保育活动的程度,以及影响儿童结核病筛查整合的因素:方法:采用横断面设计,同时使用定量和定性方法。采用简单随机抽样的方法,选取并观察了 40 名参与将结核病筛查纳入儿童常规评估的人员。对 20 名主要信息提供者进行了访谈,并就整合儿科结核病筛查进行了两次焦点小组讨论:结果:在接受评估的 302 名儿童中,只有 41.1%的儿童在评估中接受了儿童结核病筛查。使用 Wald chi-square 的二元逻辑回归模型显示,曾在门诊部(OPD)和幼儿诊所(YCC)工作过的干部对整合有显著影响,P 值为 0.002,95% CI 为(1.040-1.152);P 值为 0.002,95% CI 为(1.000-1.519)。工作 3 至 5 年的参与者在门诊部整合儿科结核病筛查的可能性是其他参与者的 7.05 倍,而工作 6 年以上的干部在青年中心整合儿科结核病筛查的可能性是其他参与者的 6.32 倍。作为一名护士或助产士,整合儿科结核病筛查的可能性更大。工作人员在筛查和评估儿童结核病方面的知识、技能和信心差距以及缺乏必要的后勤保障是已查明的障碍:结论:将儿童结核病筛查纳入手术室/YCC 常规评估的比例较低。应更多地关注 HC III,以提高卫生工作者的参与度和能力,将结核病筛查纳入卫生机构的入口点,并提供后勤服务。
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