Ending neglect: providing effective childhood tuberculosis training for health care workers in Tanzania |
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Authors: | L. V. Adams R. Olotu E. A. Talbot B. J. Cronin R. Christopher Z. Mkomwa |
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Affiliation: | 1. Infectious Disease and International Health Section, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA ;2. National Tuberculosis and Leprosy Control Programme, Dar es Salaam, Tanzania ;3. Dartmouth College, Hanover, New Hampshire, USA ;4. Tuberculosis & Human Immunodeficiency Virus (TB-HIV) Unit, Program for Appropriate Technology in Health (PATH), Dar es Salaam, Tanzania |
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Abstract: | Setting: Health care facilities in Dar es Salaam, Pwani, and Arusha, Tanzania.Objective: To assess health care worker (HCW) knowledge and practices 1 year after specialized training in childhood tuberculosis (TB).Design: Using a standardized survey, we interviewed a convenience sample of HCWs providing both general and specialized care to children.Results: We interviewed 117 HCWs in TB clinics, maternal and child health clinics, human immunodeficiency virus (HIV) clinics, out-patient departments, and pediatric in-patient wards at 12 facilities. A total of 81 HCWs (62% of nurses, 74% of clinicians) reported having attended the national childhood TB training course. Most HCWs responded correctly to questions on childhood TB diagnosis, treatment, and TB-HIV co-management, regardless of training history. Most HCWs reported that they routinely obtain chest radiographs, HIV testing, and a TB contact history when evaluating children for TB. Less than half of HCWs reported routinely obtaining sputum for mycobacterial culture or performing a tuberculin skin test. Three times as many trained as untrained HCWs reported having ever prescribed isoniazid preventive therapy (IPT) to a child (P < 0.05).Conclusion: In general, levels of childhood TB knowledge were high and practices were in accordance with national guidance. Specific gaps in diagnosis, treatment and use of IPT were identified for future focused training. |
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Keywords: | tuberculosis HIV pediatrics evaluation Tanzania |
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