PDF(Pubmed)
Abstract：
BACKGROUND: The outbreak of COVID-19 has caused a setback to the gains achieved in tuberculosis (TB) control by impairing TB diagnosis, delaying treatment initiation and aggravating TB deaths. This study explored the effect of COVID-19 on paediatric TB services provided through the Catalysing Paediatric TB Innovations (CaP-TB) project among caregivers of children receiving TB services and healthcare workers (HCWs) providing TB services in Cameroon and Kenya.
METHODS: From March to September 2021, in-depth interviews (44) were conducted with caregivers whose children under 5 years had gone through TB services and programme managers (10) overseeing the CaP-TB project. Focus group discussions were conducted with HCWs (07) and community health workers (04) supporting TB care services. Transcripts were coded and analysed by using MAXQDA V.12.
RESULTS: The COVID-19 pandemic has caused fear and anxiety among HCWs and caregivers. This fear was motivated by stigma related to COVID-19 and affected the ability to screen patients for TB due to the similarity of symptoms with COVID-19. The health-seeking behaviour of patients was affected, as many caregivers avoided hospitals and those accessing the facilities concealed their sickness due to fear of testing positive or being vaccinated. In addition, COVID-19 mitigation strategies implemented by both government and health facilities to curb the spread of the virus limited patient access to paediatric healthcare services. These included temporary closure of health facilities due to COVID-19 infections among staff, transfer of services to other spaces, spacing out patient appointments and reduced time spent with patients.
CONCLUSIONS: The outbreak of COVID-19 has induced fear and stigma that affected patients\' health-seeking behaviour and provider attitudes towards paediatric TB service delivery. In addition, facility and governmental measures put in place to mitigate COVID-19 impact negatively affected paediatric service delivery. Training for health personnel, timely provision of personal protective equipments and appropriate communication strategies could help mitigate COVID-19 impact on paediatric TB service delivery.
METHODS: From March to September 2021, in-depth interviews (44) were conducted with caregivers whose children under 5 years had gone through TB services and programme managers (10) overseeing the CaP-TB project. Focus group discussions were conducted with HCWs (07) and community health workers (04) supporting TB care services. Transcripts were coded and analysed by using MAXQDA V.12.
RESULTS: The COVID-19 pandemic has caused fear and anxiety among HCWs and caregivers. This fear was motivated by stigma related to COVID-19 and affected the ability to screen patients for TB due to the similarity of symptoms with COVID-19. The health-seeking behaviour of patients was affected, as many caregivers avoided hospitals and those accessing the facilities concealed their sickness due to fear of testing positive or being vaccinated. In addition, COVID-19 mitigation strategies implemented by both government and health facilities to curb the spread of the virus limited patient access to paediatric healthcare services. These included temporary closure of health facilities due to COVID-19 infections among staff, transfer of services to other spaces, spacing out patient appointments and reduced time spent with patients.
CONCLUSIONS: The outbreak of COVID-19 has induced fear and stigma that affected patients\' health-seeking behaviour and provider attitudes towards paediatric TB service delivery. In addition, facility and governmental measures put in place to mitigate COVID-19 impact negatively affected paediatric service delivery. Training for health personnel, timely provision of personal protective equipments and appropriate communication strategies could help mitigate COVID-19 impact on paediatric TB service delivery.
摘要：
背景：COVID-19的爆发通过损害结核病诊断，对结核病（TB）控制方面取得的成就造成了挫折，延迟开始治疗和加重结核病死亡。这项研究探讨了COVID-19对通过催化儿科结核病创新（CaP-TB）项目在喀麦隆和肯尼亚接受结核病服务的儿童护理人员和提供结核病服务的医护人员（HCWs）中提供的儿科结核病服务的影响。
方法：从2021年3月至9月，对5岁以下儿童接受过结核病服务的看护者和监督CaP-TB项目的方案管理人员（10）进行了深入访谈（44）。与支持结核病护理服务的HCWs（07）和社区卫生工作者（04）进行了焦点小组讨论。使用MAXQDAV.12对转录本进行编码和分析。
结果：COVID-19大流行引起了医护人员和护理人员的恐惧和焦虑。这种恐惧是由与COVID-19相关的耻辱引起的，由于症状与COVID-19相似，影响了筛查患者结核病的能力。病人的求医行为受到影响,因为许多护理人员避开医院，而进入设施的人由于担心检测呈阳性或接种疫苗而隐瞒了自己的疾病。此外,政府和医疗机构为遏制病毒传播而实施的COVID-19缓解战略限制了患者获得儿科医疗保健服务的机会。其中包括因工作人员感染COVID-19而暂时关闭卫生设施，将服务转移到其他空间，间隔患者预约，减少与患者在一起的时间。
结论：COVID-19的爆发引发了恐惧和耻辱，影响了患者寻求健康的行为和提供者对儿科结核病服务提供的态度。此外,为减轻COVID-19影响而采取的设施和政府措施对儿科服务的提供产生了负面影响。卫生人员培训，及时提供个人防护设备和适当的沟通策略有助于减轻COVID-19对儿科结核病服务提供的影响。
方法：从2021年3月至9月，对5岁以下儿童接受过结核病服务的看护者和监督CaP-TB项目的方案管理人员（10）进行了深入访谈（44）。与支持结核病护理服务的HCWs（07）和社区卫生工作者（04）进行了焦点小组讨论。使用MAXQDAV.12对转录本进行编码和分析。
结果：COVID-19大流行引起了医护人员和护理人员的恐惧和焦虑。这种恐惧是由与COVID-19相关的耻辱引起的，由于症状与COVID-19相似，影响了筛查患者结核病的能力。病人的求医行为受到影响,因为许多护理人员避开医院，而进入设施的人由于担心检测呈阳性或接种疫苗而隐瞒了自己的疾病。此外,政府和医疗机构为遏制病毒传播而实施的COVID-19缓解战略限制了患者获得儿科医疗保健服务的机会。其中包括因工作人员感染COVID-19而暂时关闭卫生设施，将服务转移到其他空间，间隔患者预约，减少与患者在一起的时间。
结论：COVID-19的爆发引发了恐惧和耻辱，影响了患者寻求健康的行为和提供者对儿科结核病服务提供的态度。此外,为减轻COVID-19影响而采取的设施和政府措施对儿科服务的提供产生了负面影响。卫生人员培训，及时提供个人防护设备和适当的沟通策略有助于减轻COVID-19对儿科结核病服务提供的影响。
