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Open Access Knowledge, attitudes and practices on childhood TB among healthcare workers

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BACKGROUND: Increasing childhood TB case detection requires the deployment of diagnostic services at peripheral healthcare level. Capacity and readiness of healthcare workers (HCWs) are key to the delivery of innovative approaches.

METHODS: In 2019, HCWs from five district hospitals (DHs) and 20 primary healthcare centres (PHCs) in Cambodia, Cameroon, Cote d´Ivoire, Sierra Leone and Uganda completed a self-administered knowledge-attitudes-practices (KAP) questionnaire on childhood TB. We computed knowledge and attitudes as scores and identified HCW characteristics associated with knowledge scores using linear regression.

RESULT: Of 636 eligible HCWs, 497 (78%) participated. Median knowledge scores per country ranged between 7.4 and 12.1 (/18). Median attitude scores ranged between 2.8 and 3.3 (/4). Between 13.3% and 34.4% of HCWs reported diagnosing childhood with (presumptive) TB few times a week. Practising at PHC level, being female, being involved in indirect TB care, having a non-permanent position, having no previous research experience and working in Cambodia, Cameroon, Cote d´Ivoire and Sierra Leone as compared to Uganda were associated with a lower knowledge score.

CONCLUSION: HCWs had overall limited knowledge, favourable attitudes and little practice of childhood TB diagnosis. Increasing HCW awareness, capacity and skills, and improving access to effective diagnosis are urgently needed.

Keywords: LMICs; childhood TB; healthcare workers; knowledge; tuberculosis

Document Type: Research Article

Affiliations: 1: Unité mixte de recherche 1219, University of Bordeaux, Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France 2: Unité mixte de recherche 1219, University of Bordeaux, Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France 3: Makerere University–Johns Hopkins University (MU-JHU) Research Collaboration, MU-JHU Care Limited, Kampala, Uganda 4: Epicentre Mbarara Research Centre, Mbarara, Uganda 5: National Tuberculosis and Leprosy Program, Kampala, Uganda 6: Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia 7: Centre national de Lutte contre la Tuberculose et la Lèpre (CENAT), Phnom Penh, Cambodia 8: Programme ANRS Coopération Côte d´Ivoire (PAC-CI) Abidjan, Côte d´Ivoire 9: Programme National de Lutte contre la Tuberculose (PNLT), Abidjan, Côte d´Ivoire 10: Solthis, Paris, France 11: Ola During Children´s Hospital, Freetown, Sierra Leone 12: Solthis, Freetown, Sierra Leone 13: National Leprosy and TB Control Programme, Freetown, Sierra Leone 14: Child and Community Health Unit, United Nations Children´s Fund (UNICEF), New York, NY, USA 15: Global Tuberculosis Programme, WHO, Geneva, Switzerland 16: Instituto Nacional de Saúde, Maputo, Mozambique 17: PNLT, Yaoundé, Cameroon 18: Mother and Child Centre, Chantal Biya Foundation, Yaoundé, Cameroon 19: IRD, Yaoundé, Cameroon 20: TransVIHMI (Recherches Translationnelles sur le VIH et les Maladies Infectieuses), University of Montpellier, IRD, INSERM, Montpellier, France

Publication date: March 1, 2022

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