Assessing the impact of multidrug-resistant tuberculosis in children : an exploratory qualitative study

Franck, Caroline; Seddon, James A.; Hesseling, Anneke C.; Schaaf, H. Simon; Skinner, Donald; Reynolds, Lucy

Assessing the impact of multidrug-resistant tuberculosis in children : an exploratory qualitative study

dc.contributor.author	Franck, Caroline	en_ZA
dc.contributor.author	Seddon, James A.	en_ZA
dc.contributor.author	Hesseling, Anneke C.	en_ZA
dc.contributor.author	Schaaf, H. Simon	en_ZA
dc.contributor.author	Skinner, Donald	en_ZA
dc.contributor.author	Reynolds, Lucy	en_ZA
dc.date.accessioned	2014-09-16T09:22:35Z
dc.date.available	2014-09-16T09:22:35Z
dc.date.issued	2014-08
dc.date.updated	2014-08-06T11:05:18Z
dc.description	Please cite as follows: Franck, C. et al. 2014. Assessing the impact of multidrug-resistant tuberculosis in children: an exploratory qualitative study. BMC Infectious Diseases, 14(1):426, doi:10.1186/1471-2334-14-426.	en_ZA
dc.description	The original publication is available at http://www.biomedcentral.com/1471-2334/14/426	en_ZA
dc.description	Publication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstract	Background: While the prevalence of multidrug-resistant (MDR) tuberculosis (TB) is high among children in the Western Cape of South Africa, the psychosocial implications of treatment for children with MDR-TB remain poorly understood. We sought to explore how MDR-TB and its treatment impact children on an individual, familial, and social level. Methods: Semi-structured interviews were conducted with 20 children and caregivers purposively sampled from a prospective clinical cohort of children. The sample was stratified by age at the start of treatment (children >10 years, and 5-10 years). Caregiver proxy interviews were conducted with younger children, supplemented with child interviews; older children were interviewed directly, supplemented with caregiver proxy interviews. Data were analysed using grounded theory. Results: Findings revealed pill volume and adverse effects produced significant physical, psychological and academic disturbances in children. Adverse effects related to the medication were important obstacles to treatment adherence. While there appear to be no long-lasting effects in younger children, a few older children showed evidence of persisting internalised stigma. Caregivers suffered important treatment-related financial and psychological costs. Community support, notably through the continued involvement of children in strong social networks, promoted resilience among children and their families. Conclusions: We found that the current treatment regimen for childhood MDR-TB has significant psychological, academic, and financial impacts on children and their families. There is a need for psychosocial support of children and caregivers to mitigate the negative effects of community stigma, and to manage the stressors associated with chronic illness.	en_ZA
dc.description.version	Publishers’ version	en_ZA
dc.identifier.citation	Franck, C. et al. 2014. Assessing the impact of multidrug-resistant tuberculosis in children: an exploratory qualitative study. BMC Infectious Diseases, 14(1):426, doi:10.1186/1471-2334-14-426.	en_ZA
dc.identifier.issn	1471-2334 (online)	en_ZA
dc.identifier.other	doi:10.1186/1471-2334-14-426
dc.identifier.uri	http://hdl.handle.net/10019.1/95552
dc.language.iso	en_ZA	en_ZA
dc.publisher	BioMed Central	en_ZA
dc.rights.holder	Caroline Franck et al.; licensee BioMed Central Ltd.	en_ZA
dc.subject	Multidrug-resistant tuberculosis	en_ZA
dc.subject	Tuberculosis in children	en_ZA
dc.title	Assessing the impact of multidrug-resistant tuberculosis in children : an exploratory qualitative study	en_ZA
dc.type	Article	en_ZA