1
|
Sparg T, Petersen L, Mayers P, Rogers C. South African adolescents' lived experiences of acquired hearing loss following multidrug-resistant tuberculosis treatment. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1336346. [PMID: 38469378 PMCID: PMC10925655 DOI: 10.3389/fresc.2024.1336346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/10/2024] [Indexed: 03/13/2024]
Abstract
Objective The impact of acquiring hearing loss might be exacerbated during adolescence, as this normal transition from childhood to adulthood is characterised by identity construction and social intensity. This study aimed to describe the lived experiences of South African adolescents with acquired hearing loss following aminoglycoside treatment for multidrug resistant tuberculosis. Design The study adopted a descriptive phenomenological design and in-depth, semi-structured interviews were conducted in English, isiZulu and Afrikaans. The data was managed and analysed according to a modified version of Hycner's framework. Study sample Six participants aged 16-24 years with bilateral, mild to profound hearing loss acquired from aminoglycoside treatment were recruited from two South African provinces. Results Three themes emerged which created a triple burden for participants. They endured socio-economic hardship encompassing limited economic and emotional support. Participants battled the consequences of life-threatening MDR-TB including illness, hospitalisation, stigma, and other challenges. Finally, participants were left with life-changing hearing loss. Conclusion The findings indicate the necessity of holistic management of adolescents with aminoglycoside-related acquired hearing loss and serves as motivation to improve ototoxic monitoring practices and patient uptake of monitoring services and calls for the cessation, or at least cautious use, of aminoglycosides.
Collapse
Affiliation(s)
- Tarryn Sparg
- Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lucretia Petersen
- Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Pat Mayers
- Division of Nursing and Midwifery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Christine Rogers
- Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
2
|
Chiang SS, Waterous PM, Atieno VF, Bernays S, Bondarenko Y, Cruz AT, de Oliveira MCB, Del Castillo Barrientos H, Enimil A, Ferlazzo G, Ferrand RA, Furin J, Hoddinott G, Isaakidis P, Kranzer K, Maleche-Obimbo E, Mansoor H, Marais BJ, Mohr-Holland E, Morales M, Nguyen AP, Oliyo JO, Sant'Anna CC, Sawyer SM, Schaaf HS, Seddon JA, Sharma S, Skrahina A, Starke JR, Triasih R, Tsogt B, Welch H, Enane LA. Caring for Adolescents and Young Adults With Tuberculosis or at Risk of Tuberculosis: Consensus Statement From an International Expert Panel. J Adolesc Health 2023; 72:323-331. [PMID: 36803849 PMCID: PMC10265598 DOI: 10.1016/j.jadohealth.2022.10.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/25/2022] [Indexed: 02/19/2023]
Abstract
Background: Despite being a preventable and treatable disease, tuberculosis (TB) is a leading cause of death among young people globally. Each year, an estimated 1.8 million adolescents and young adults (AYAs; 10–24 years old) develop TB. In 2019, an estimated 161,000 AYAs died of the disease. AYAs have unique developmental, psychosocial, and healthcare needs, but these needs have been neglected in both TB care and research agendas. In order to improve outcomes in this age group, the specific needs of AYAs must be considered and addressed. Methods: Through a consensus process, an international panel of 34 clinicians, researchers, TB survivors, and advocates with expertise in child/adolescent TB and/or adolescent health proposed interventions for optimizing AYA engagement in TB care. The process consisted of reviewing the literature on TB in AYAs; identifying and discussing priority areas; and drafting and revising proposed interventions until consensus, defined a priori , was reached. Results: The panel acknowledged the dearth of evidence on best practices for identifying and managing AYAs with TB. The final consensus statement, based on expert opinion, proposes nine interventions to reform current practices that may harm AYA health and well-being, and nine interventions to establish high-quality AYA-centered TB services. Conclusion: AYA-specific interventions for TB care and research are critical for improving outcomes in this age group. In the absence of evidence on best practices, this consensus statement from an international group of experts can help address the needs of AYA with TB or at risk for TB.
Collapse
Affiliation(s)
- Silvia S Chiang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island; Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island.
| | - Patricia M Waterous
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Sarah Bernays
- School of Public Health, University of Sydney, Sydney, Australia; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yaroslava Bondarenko
- Department of Phthisiology and Pulmonology, Bogomolets National Medical University, Kyiv, Ukraine
| | - Andrea T Cruz
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Márcia C B de Oliveira
- Department of Pediatrics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Pediatrics, Souza Marques School of Medicine, Rio de Janeiro, Brazil
| | | | - Anthony Enimil
- Child Health Department, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Child Health Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Gabriella Ferlazzo
- Médecins Sans Frontières, Cape Town, South Africa; Médecins Sans Frontières, Mumbai, India
| | - Rashida Abbas Ferrand
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Jennifer Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts; Sentinel Project on Pediatric Drug-Resistant Tuberculosis, Boston, Massachusetts
| | - Graeme Hoddinott
- Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa
| | - Petros Isaakidis
- Médecins Sans Frontières, Cape Town, South Africa; Médecins Sans Frontières, Mumbai, India
| | - Katharina Kranzer
- School of Public Health, University of Sydney, Sydney, Australia; Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | | | - Ben J Marais
- Sydney Infectious Diseases Institute (Sydney ID), University of Sydney, Sydney, Australia; Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, Australia
| | | | | | | | | | - Clemax Couto Sant'Anna
- Department of Pediatrics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital and Murdoch Children's Research Institute, Melbourne, Australia; Department of Peadiatrics, The University of Melbourne, Melbourne, Australia
| | - H Simon Schaaf
- Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa
| | - James A Seddon
- Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa; Department of Infectious Diseases, Imperial College London, London, United Kingdom
| | - Sangeeta Sharma
- Department of Paediatrics, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Alena Skrahina
- Clinical Department, The Republican Research and Practica Centre for Pulmonology and TB, Minsk, Belarus
| | - Jeffrey R Starke
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Rina Triasih
- Department of Pediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | | | - Henry Welch
- Department of Pediatrics, Souza Marques School of Medicine, Rio de Janeiro, Brazil; Department of Pediatrics, School of Medicine and Health Sciences, The University of Papua New Guinea, Port Moresby, Papua New Guinea; Port Moresby General Hospital, Port Moresby, Papua New Guinea
| | - Leslie A Enane
- Department of Pediatrics, The Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, Indiana; Indiana University Center for Global Health, Indianapolis, Indiana.
| |
Collapse
|
3
|
Li W, Yu H, Zhang Y, Li B, Fu M. Psychometric evaluation of the Chinese version of fear of hospitalization scale among outpatients: A validation study. Front Psychol 2023; 13:1095905. [PMID: 36710810 PMCID: PMC9875798 DOI: 10.3389/fpsyg.2022.1095905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023] Open
Abstract
Background In China, some patients avoid seeking medical care and are highly sensitive to subsequent medical care because of fear of possible hospitalization after a diagnosis has been established. Early identification of fear of hospitalization is essential for clinical staff to develop targeted education and interventions. However, there are currently no tools to assess outpatients' fear of hospitalization in mainland China. This study aimed to translate the Fear of Hospitalization (FH) scale into Chinese and verify its reliability and validity in outpatients. Methods Through convenience sampling, 664 outpatients who required hospitalization were recruited from two cities in Liaoning Province, China. The reliability of the translated scale was measured by internal consistency, split-half reliability, and test-retest reliability. The validity of the translated scale was evaluated by expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States). Results The Cronbach's α value of the Chinese version of the FH scale was 0.849, and the Cronbach's α value of the dimensions ranged from 0.857 to 0.902. The test-retest reliability value of 0.868 shows good temporal stability. The split-half reliability value of 0.910 indicates a high degree of measuring the same content. The content validity index of the scale (S-CVI) was 0.924, indicating a good level of content validity. The 3-factor structure supported by eigenvalues, total variance explained, and scree plot was obtained using exploratory factor analysis. In addition, all recommended fit indicators were within the acceptable range by confirmatory factor analysis. Conclusion The Chinese version of the FH scale is valid and reliable in outpatients. The developed three-factor structured scale will help identify outpatients with a high fear of hospitalization and can inform the development of educational intervention plans for care managers, physicians, and nurses. In addition, it helps clinicians and nurses take action to reduce this fear of hospitalization in patients and prevent avoidance of using health care services due to fear of hospitalization.
Collapse
Affiliation(s)
- Wenbo Li
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Hongyu Yu
- Department of Nursing, Jinzhou Medical University, Jinzhou, China,*Correspondence: Hongyu Yu,
| | - Yanli Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Bing Li
- Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mingshu Fu
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| |
Collapse
|
4
|
Oliva Rapoport VE, Altamirano E, Senador L, Wong M, Beckhorn CB, Coit J, Roche SD, Lecca L, Galea JT, Chiang SS. Impact of prolonged isolation on adolescents with drug-susceptible tuberculosis in Lima, Peru: a qualitative study. BMJ Open 2022; 12:e063287. [PMID: 36127091 PMCID: PMC9490619 DOI: 10.1136/bmjopen-2022-063287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Patients with tuberculosis (TB) generally are instructed to isolate at the beginning of treatment in order to prevent disease transmission. The duration of isolation varies and may be prolonged (ie, lasting 1 month or more). Few studies have examined the impact of isolation during TB treatment on adolescents, who may be more vulnerable to its negative effects. METHODS This study took place from 2018 through 2019 in Lima, Peru, where the Ministry of Health mandates the exclusion of patients with TB from educational institutions for at least 2 months. Using semi-structured guides, we conducted individual in-depth interviews with adolescents who received treatment for drug-susceptible TB, their primary caregivers and health providers. We performed thematic analysis of the transcribed interviews. RESULTS We interviewed 85 participants: 34 adolescents, 36 caregivers and 15 healthcare workers. At the time of their TB diagnoses, 28 adolescents were in secondary, postsecondary, vocational or military school. Adolescents with drug-susceptible TB were prescribed home isolation usually for 2 (and occasionally for 1) months. Consequently, they could neither attend school nor socialise with family members or friends. Two primary themes emerged from the interviews. First, as a result of their exclusion from school, most adolescents fell behind academically and had to repeat a semester or academic year. Second, absence from school, separation from friends and loved ones, and reinforcement of TB-related stigma (arising from fear of TB transmission) harmed adolescents' mental health. CONCLUSION Prolonged isolation led to educational setbacks and emotional trauma among adolescents with TB. Prolonged isolation is not supported by current evidence on TB transmission and is problematic from a human rights perspective, as it violates adolescents' rights to education and freedom of movement. Isolation recommendations should be re-evaluated to align with data on TB transmission and the principles of patient-centred care.
Collapse
Affiliation(s)
| | | | | | | | | | - Julia Coit
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephanie D Roche
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Institute, Seattle, Washington, USA
| | - Leonid Lecca
- Socios En Salud Sucursal Peru, Lima, Peru
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jerome T Galea
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Silvia S Chiang
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| |
Collapse
|
5
|
Moscibrodzki P, Enane LA, Hoddinott G, Brooks MB, Byron V, Furin J, Seddon JA, Meyersohn L, Chiang SS. The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults. Pathogens 2021; 10:1591. [PMID: 34959546 PMCID: PMC8706072 DOI: 10.3390/pathogens10121591] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 01/26/2023] Open
Abstract
The health needs of adolescents and young adults (AYAs) have been neglected in tuberculosis (TB) care, control, and research. AYAs, who are distinct from younger children and older adults, undergo dynamic physical, psychological, emotional, cognitive, and social development. Five domains of adolescent well-being are crucial to a successful transition between childhood and adulthood: (1) Good health; (2) connectedness and contribution to society; (3) safety and a supportive environment; (4) learning, competence, education, skills, and employability; and (5) agency and resilience. This review summarizes the evidence of the impact of TB disease and treatment on these five domains of AYA well-being.
Collapse
Affiliation(s)
- Patricia Moscibrodzki
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Leslie A. Enane
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (G.H.); (J.A.S.)
| | - Meredith B. Brooks
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; (M.B.B.); (V.B.); (J.F.)
| | - Virginia Byron
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; (M.B.B.); (V.B.); (J.F.)
| | - Jennifer Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; (M.B.B.); (V.B.); (J.F.)
- Sentinel Project on Pediatric Drug-Resistant Tuberculosis, Boston, MA 02115, USA
| | - James A. Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa; (G.H.); (J.A.S.)
- Department of Infectious Diseases, Imperial College London, London W2 1NY, UK
| | - Lily Meyersohn
- Center for International Health Research, Rhode Island Hospital, Providence, RI 02903, USA; (L.M.); (S.S.C.)
| | - Silvia S. Chiang
- Center for International Health Research, Rhode Island Hospital, Providence, RI 02903, USA; (L.M.); (S.S.C.)
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI 02903, USA
| |
Collapse
|
6
|
Zawedde-Muyanja S, Reuter A, Tovar MA, Hussain H, Loando Mboyo A, Detjen AK, Yuen CM. Provision of Decentralized TB Care Services: A Detect-Treat-Prevent Strategy for Children and Adolescents Affected by TB. Pathogens 2021; 10:1568. [PMID: 34959523 PMCID: PMC8705395 DOI: 10.3390/pathogens10121568] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
In this review, we discuss considerations and successful models for providing decentralized diagnosis, treatment, and prevention services for children and adolescents. Key approaches to building decentralized capacity for childhood TB diagnosis in primary care facilities include provider training and increased access to child-focused diagnostic tools and techniques. Treatment of TB disease should be managed close to where patients live; pediatric formulations of both first- and second-line drugs should be widely available; and any hospitalization should be for as brief a period as medically indicated. TB preventive treatment for child and adolescent contacts must be greatly expanded, which will require home visits to identify contacts, building capacity to rule out TB, and adoption of shorter preventive regimens. Decentralization of TB services should involve the private sector, with collaborations outside the TB program in order to reach children and adolescents where they first enter the health care system. The impact of decentralization will be maximized if programs are family-centered and designed around responding to the needs of children and adolescents affected by TB, as well as their families.
Collapse
Affiliation(s)
- Stella Zawedde-Muyanja
- The Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala P.O. Box 22418, Uganda
| | - Anja Reuter
- Médecins Sans Frontières, Cape Town 7784, South Africa;
| | - Marco A. Tovar
- Socios En Salud Sucursal Perú, Lima 15001, Peru;
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru
| | - Hamidah Hussain
- Interactive Research and Development Global, Singapore 238884, Singapore;
| | - Aime Loando Mboyo
- Elizabeth Glaser Pediatric AIDS Foundation, Kinshasa B.P. 1002030, Democratic Republic of the Congo;
| | - Anne K. Detjen
- United Nations Children’s Fund, New York, NY 10017, USA;
| | - Courtney M. Yuen
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA;
| |
Collapse
|