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Research article
Nicole Salazar-Austin
Johns Hopkins University School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9875-9319
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Tuberculosis is a top-10 cause of under-5 mortality, despite policies promoting tuberculosis preventive therapy (TPT). We previously conducted a cluster randomized trial to evaluate the effectiveness of symptom-based versus tuberculin skin-based screening on child TPT uptake. Symptom-based screening did not improve TPT uptake and nearly two-thirds of child contacts were not identified or not linked to care. Here we qualitatively explored healthcare provider perceptions of factors that impacted TPT uptake among child contacts.
Methods: Sixteen in-depth interviews were conducted with key informants including healthcare providers and administrators who participated in the trial in Matlosana, South Africa. The participants’ experience with symptom-based screening, study implementation strategies, and ongoing challenges with child contact identification and linkage to care were explored. Interviews were systematically coded and thematic content analysis was conducted.
Results: Participants’ had mixed opinions about symptom-based screening and high acceptability of the study implementation strategies. A key barrier to optimizing child contact screening and evaluation was the supervision and training of community health workers.
Conclusions: Symptom screening is a simple and effective strategy to evaluate child contacts, but additional pediatric training is needed to provide comfort with decision making. New clinic-based child contact files were highly valued by providers who continued to use them after trial completion. Future interventions to improve child contact management will need to address how to best utilize community health workers in identifying and linking child contacts to care.
Trial Registration: The results presented here were from research related to NCT03074799, retrospectively registered on 9 March 2017.
Keywords
tuberculosis preventive therapy (TPT), Matlosana, key barrier, Future interventions
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CURRENT STATUS: Published
View the published article at BMC Nursing.
Version 3
Posted 18 Jan, 2021
No community comments so far
Submission checks complete
On 09 Jan, 2021
Editorial decision: Accept
On 05 Jan, 2021
No comments provided
Review #1 received
Received 02 Dec, 2020
Reviewer #3 agreed
On 30 Nov, 2020
Reviewer #2 agreed
On 26 Nov, 2020
Reviewer #1 agreed
On 22 Nov, 2020
Reviewers invited
Invitations sent on 18 Nov, 2020
Editor assigned
On 17 Nov, 2020
Submission checks complete
On 17 Nov, 2020
Editor invited
On 17 Nov, 2020
No comments provided
Editorial decision: Major revision
On 17 Oct, 2020
Review #2 received
Received 16 Oct, 2020
Review #1 received
Received 07 Oct, 2020
Reviewer #2 agreed
On 23 Sep, 2020
Reviewer #1 agreed
On 15 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Editor assigned
On 25 Aug, 2020
Submission checks complete
On 24 Aug, 2020
Editor invited
On 24 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nursing
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Nursing.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Nicole Salazar-Austin
Johns Hopkins University School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9875-9319
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Nursing.
Version 3
Posted 18 Jan, 2021
No community comments so far
Submission checks complete
On 09 Jan, 2021
Editorial decision: Accept
On 05 Jan, 2021
No comments provided
Review #1 received
Received 02 Dec, 2020
Reviewer #3 agreed
On 30 Nov, 2020
Reviewer #2 agreed
On 26 Nov, 2020
Reviewer #1 agreed
On 22 Nov, 2020
Reviewers invited
Invitations sent on 18 Nov, 2020
Editor assigned
On 17 Nov, 2020
Submission checks complete
On 17 Nov, 2020
Editor invited
On 17 Nov, 2020
No comments provided
Editorial decision: Major revision
On 17 Oct, 2020
Review #2 received
Received 16 Oct, 2020
Review #1 received
Received 07 Oct, 2020
Reviewer #2 agreed
On 23 Sep, 2020
Reviewer #1 agreed
On 15 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Editor assigned
On 25 Aug, 2020
Submission checks complete
On 24 Aug, 2020
Editor invited
On 24 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nursing
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Nursing.
Background: Tuberculosis is a top-10 cause of under-5 mortality, despite policies promoting tuberculosis preventive therapy (TPT). We previously conducted a cluster randomized trial to evaluate the effectiveness of symptom-based versus tuberculin skin-based screening on child TPT uptake. Symptom-based screening did not improve TPT uptake and nearly two-thirds of child contacts were not identified or not linked to care. Here we qualitatively explored healthcare provider perceptions of factors that impacted TPT uptake among child contacts.
Methods: Sixteen in-depth interviews were conducted with key informants including healthcare providers and administrators who participated in the trial in Matlosana, South Africa. The participants’ experience with symptom-based screening, study implementation strategies, and ongoing challenges with child contact identification and linkage to care were explored. Interviews were systematically coded and thematic content analysis was conducted.
Results: Participants’ had mixed opinions about symptom-based screening and high acceptability of the study implementation strategies. A key barrier to optimizing child contact screening and evaluation was the supervision and training of community health workers.
Conclusions: Symptom screening is a simple and effective strategy to evaluate child contacts, but additional pediatric training is needed to provide comfort with decision making. New clinic-based child contact files were highly valued by providers who continued to use them after trial completion. Future interventions to improve child contact management will need to address how to best utilize community health workers in identifying and linking child contacts to care.
Trial Registration: The results presented here were from research related to NCT03074799, retrospectively registered on 9 March 2017.
This is a list of supplementary files associated with this preprint. Click to download.
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