Survey of health care worker knowledge about childhood tuberculosis in high-burden centers in Botswana
METHODS: Semi-structured interviews were conducted with HCWs at 46 sites around Botswana using a piloted instrument. Transcripts were double-coded using a coding schema. Discrepancies were resolved by consensus and a systematic thematic analysis was performed.
RESULTS: The sites (42 clinics and 4 hospitals) were urban (n = 9, 20%), semi-urban (n = 10, 22%) and rural (n = 27, 58%). HCWs included nurses (n = 42, 89%) and nurse assistants (n = 4, 11%). Sixteen (56%) HCWs were the TB focal persons for their site. Themes did not vary by type of site, HCW or TB focal person. Although the level of knowledge about secondary prevention using isoniazid prophylaxis therapy was fair, implementation was poor and contact tracing was not being performed. Barriers to TB diagnosis included poor knowledge about TB in the community, minimal diagnostics at site of care and not receiving test results. However, most HCWs reported that treatment initiation and the calculation of appropriate dosages were easy once the diagnosis had been made.
CONCLUSIONS: In Botswana, HCWs' levels of knowledge about childhood TB varied greatly. The areas of TB diagnosis, screening and prophylaxis in children need additional attention in TB training courses; however, increased knowledge alone would not overcome all the barriers identified by the HCWs.
Document Type: Research Article
Affiliations: 1: University of Pennsylvania, Philadelphia, Pennsylvania, USA, Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, Botswana–UPenn Partnership, Gaborone 2: Botswana–UPenn Partnership, Gaborone 3: Botswana's National TB Program, Ministry of Health, Gaborone, Botswana, International Union Against Tuberculosis and Lung Disease, Harare, Zimbabwe
Publication date: May 1, 2017
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.
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