Artigo Acesso aberto Revisado por pares

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

2022; BioMed Central; Volume: 8; Issue: 1 Linguagem: Inglês

10.1186/s40814-022-00996-3

ISSN

2055-5784

Autores

Anca Vasiliù, Georges Tiendrebéogo, Mbunka Muhamed Awolu, Cecilia Akatukwasa, Boris Tchakounte Youngui, Bob Ssekyanzi, Boris Tchounga, Daniel Atwine, Martina Casenghi, Maryline Bonnet, Maryline Bonnet, Anca Vasiliù, Savine Chauvet, Elisabete de Carvalho, Sayouba Ouédraogo, Georges Tiendrebéogo, Martina Casenghi, Jennifer Cohn, Boris Tchounga, Boris Tchakounte Youngui, Collette Sih, Rogacien Kana, Éric Youm, Patrice Tchengou, L. Simo, Paul W. Manguele, Paul Bindzi, M. Ndongo, Doline Ndjang Kombou, Jinette L. Guedem Nekame, Narcisse Sitamze Kaptue, Philippe Narcisse Tsigaing, Mbunka Muhamed Awolu, Leticia G. Seuleu Ndjamakou, Naomi Chi Ndum, Daniel Atwine, Bob Ssekyanzi, Rinah Arinaitwe, David Otai, Cecilia Akatukwasa, Joanita Berytah Tebulwa, Hamidah Kamanzi, Agnes Natukunda, Eva Natukunda, Rose Kyarimpa, Doreen Kyomuhendo, Scovia Sanyu, John Ssemanya, Richard Okello, Albert Kuate Kuate, Stavia Turyahabwe, Hamish Graham, Peter J. Dodd, Nyashadzaishe Mafirakureva, Sushant Mukherjee,

Tópico(s)

Pneumocystis jirovecii pneumonia detection and treatment

Resumo

One of the main barriers of the management of household tuberculosis child contacts is the necessity for parents to bring healthy children to the facility. We assessed the feasibility of a community intervention for tuberculosis (TB) household child contact management and the conditions for its evaluation in a cluster randomized controlled trial in Cameroon and Uganda.We assessed three dimensions of feasibility using a mixed method approach: (1) recruitment capability using retrospective aggregated data from facility registers; (2) acceptability of the intervention using focus group discussions with TB patients and in-depth interviews with healthcare providers and community leaders; and (3) adaptation, integration, and resources of the intervention in existing TB services using a survey and discussions with stakeholders.Reaching the sample size is feasible in all clusters in 15 months with the condition of regrouping 2 facilities in the same cluster in Uganda due to decentralization of TB services. Community health worker (CHW) selection and training and simplified tools for contact screening, tolerability, and adherence of preventive therapy were key elements for the implementation of the community intervention. Healthcare providers and patients found the intervention of child contact investigations and TB preventive treatment management in the household acceptable in both countries due to its benefits (competing priorities, transport cost) as compared to facility-based management. TB stigma was present, but not a barrier for the community intervention. Visit schedule and team conduct were identified as key facilitators for the intervention.This study shows that evaluating a community intervention for TB child contact management in a cluster randomized trial is feasible in Cameroon and Uganda.Clini calTr ials. gov NCT03832023 . Registered on February 6th 2019.

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