Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town
Introduction Adolescents’ experiences (10–19 years-old) with tuberculosis (TB) remain poorly understood. Descriptions of adolescent TB experiences, particularly how they interact with the health system, are scarce. We aimed to understand adolescents’ experiences of TB health services in the Western...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/5/e094295.full |
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| author | Graeme Hoddinott James Seddon Khanyisa Mcimeli Stephanie Jacobs Dillon Timothy Wademan Zara Kavalieratos Mfundo Mlomzale Arlene J Marthinus Lucia N Jola |
| author_facet | Graeme Hoddinott James Seddon Khanyisa Mcimeli Stephanie Jacobs Dillon Timothy Wademan Zara Kavalieratos Mfundo Mlomzale Arlene J Marthinus Lucia N Jola |
| author_sort | Graeme Hoddinott |
| collection | DOAJ |
| description | Introduction Adolescents’ experiences (10–19 years-old) with tuberculosis (TB) remain poorly understood. Descriptions of adolescent TB experiences, particularly how they interact with the health system, are scarce. We aimed to understand adolescents’ experiences of TB health services in the Western Cape, South Africa. We focused on how TB services were aided or hindered through interactions with healthcare providers and health system processes.Methods Teen TB, an observational study in Cape Town, enrolled 50 newly diagnosed adolescents with multidrug-resistant and drug-susceptible TB. A subset of 20 was selected for serial qualitative data collection, with 19 completing all tasks between December 2020 and September 2021. 52 interviews were conducted and thematically analysed using a case descriptive process for experiences across the TB care cascade.Findings Adolescents criticised the difficulties and delays they encountered in obtaining an accurate TB diagnosis. Initial misdiagnoses and delayed TB diagnoses were reported, despite seeking help from multiple healthcare providers at different facilities. Adolescents questioned whether the financial, social and emotional costs of TB care outweighed the costs of delaying treatment initiation and adherence. Adolescents reported that the treatment regimen, adherence support processes and interactions with the health system posed significant challenges to maintaining adherence. Encouragingly, however, most adolescents reported being well treated and cared for by health workers.Conclusion Our study shows that adolescents experience challenges throughout their TB treatment journeys. More adolescent-focused research is needed to tailor treatment and healthcare processes to their needs. |
| format | Article |
| id | doaj-art-1cfc385a8eb843218ae47eeddd9587d3 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-1cfc385a8eb843218ae47eeddd9587d32025-08-20T03:48:19ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-094295Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape TownGraeme Hoddinott0James Seddon1Khanyisa Mcimeli2Stephanie Jacobs3Dillon Timothy Wademan4Zara Kavalieratos5Mfundo Mlomzale6Arlene J Marthinus7Lucia N Jola8Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South AfricaIntroduction Adolescents’ experiences (10–19 years-old) with tuberculosis (TB) remain poorly understood. Descriptions of adolescent TB experiences, particularly how they interact with the health system, are scarce. We aimed to understand adolescents’ experiences of TB health services in the Western Cape, South Africa. We focused on how TB services were aided or hindered through interactions with healthcare providers and health system processes.Methods Teen TB, an observational study in Cape Town, enrolled 50 newly diagnosed adolescents with multidrug-resistant and drug-susceptible TB. A subset of 20 was selected for serial qualitative data collection, with 19 completing all tasks between December 2020 and September 2021. 52 interviews were conducted and thematically analysed using a case descriptive process for experiences across the TB care cascade.Findings Adolescents criticised the difficulties and delays they encountered in obtaining an accurate TB diagnosis. Initial misdiagnoses and delayed TB diagnoses were reported, despite seeking help from multiple healthcare providers at different facilities. Adolescents questioned whether the financial, social and emotional costs of TB care outweighed the costs of delaying treatment initiation and adherence. Adolescents reported that the treatment regimen, adherence support processes and interactions with the health system posed significant challenges to maintaining adherence. Encouragingly, however, most adolescents reported being well treated and cared for by health workers.Conclusion Our study shows that adolescents experience challenges throughout their TB treatment journeys. More adolescent-focused research is needed to tailor treatment and healthcare processes to their needs.https://bmjopen.bmj.com/content/15/5/e094295.full |
| spellingShingle | Graeme Hoddinott James Seddon Khanyisa Mcimeli Stephanie Jacobs Dillon Timothy Wademan Zara Kavalieratos Mfundo Mlomzale Arlene J Marthinus Lucia N Jola Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town BMJ Open |
| title | Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town |
| title_full | Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town |
| title_fullStr | Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town |
| title_full_unstemmed | Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town |
| title_short | Understanding the relationship between adolescents with tuberculosis and health services: an indepth qualitative study from Cape Town |
| title_sort | understanding the relationship between adolescents with tuberculosis and health services an indepth qualitative study from cape town |
| url | https://bmjopen.bmj.com/content/15/5/e094295.full |
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