Caregiver perspectives on TB case-finding and HIV clinical services for children diagnosed with TB in Tanzania

ABSTRACT

Caregivers of children with tuberculosis (TB) and HIV play a critical role in seeking healthcare for their children. To assess the perspectives of caregivers of pediatric TB patients, we conducted 76 in-depth interviews at 10 TB clinics in 5 districts of Tanzania in March 2016. We assessed how the child received their TB diagnosis, the decision-making process around testing the child for HIV, and the process of linking the child to HIV treatment in the event of an HIV diagnosis. Caregivers suspected TB due to cases in their family, or the child being ill and not improving. Most caregivers noted delays before confirmation of a TB diagnosis and having to visit multiple facilities before a diagnosis. Once diagnosed, some caregivers reported challenges administering TB medications due to lack of pediatric formulations. Reasons for accepting HIV testing included recurrent illness and HIV symptoms, history of HIV in the family, and recommendation of the clinical provider. Caregivers described a relatively seamless process for linking their child to HIV treatment, highlighting the success of TB/HIV integration efforts. The multiple clinic visits required prior to TB diagnosis suggests the need for additional training and sensitization of healthcare workers and better TB diagnostic tools.

KEYWORDS:

• Tuberculosis
• HIV
• Tanzania
• children
• qualitative
• linkage to care

Acknowledgements

The authors are grateful to the caregivers of pediatric TB patients who participated in this evaluation. We recognize the Tanzania National TB and Leprosy Program for their leadership and collaboration.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work has been supported by the U.S. President Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention, under the terms of [grant number 1U2GP002751].