Perceptions and challenges among health care providers about HIV-TB co-infected children- A qualitative study.

BACKGROUND: Human immunodeficiency virus - Tuberculosis (HIV-TB) co-infected patients have a greater risk of mortality, treatment failure, and recurrence. The significant morbidity and mortality rates associated with tuberculosis and human immunodeficiency virus infection in children cause concern. India aims to enhance the detection and treatment of HIV-TB cases in children and coordinate TB & HIV care. OBJECTIVE: To explore the perceptions and challenges of health care providers regarding the diagnosis and treatment of Tuberculosis in HIV-TB co-infected children. MATERIALS AND METHOD: In-depth interviews among 14 health care providers were conducted in ART centers of 5 talukas of Belagavi district to identify health care providers' perceptions and challenges regarding pediatric HIV-TB diagnosis and treatment. Interviews were conducted after receiving informed consent. RESULTS: Challenges during HIV-TB diagnosis and treatment in children: difficult to get sputum sample for CBNAAT and child was unable to complain about symptoms, caregivers were not able to mention the signs/symptoms correctly, unavailability of a pediatrician in few Taluka ART centers, delay in receiving TB lab report, challenging to feed drugs to an infant, higher loss to follow-up, financial problem, distance from centers, low community awareness, poverty and illiteracy, stigma and death due to TB treatment default. CONCLUSION: Efforts such as expanded health care providers, community education, and a constant supply of HIV rapid test kits are required to ensure successful diagnosis and treatment of HIV-TB co-infected children.

Effect of pandemic on DOTS treatment during COVID-19 lockdown- A cross-sectional study.

BACKGROUND: Tuberculosis (TB) is still the most common infectious disease globally, affecting 1.5 million people per year. Prior to COVID-19 outbreak, India was struggling with a rampant attack of Tuberculosis. With the surge of COVID-19 implementation of all national health programs including NTEP was disrupted. Prioritization of services, the challenges to reaching all types of communities and the role of stigmatization, and the possibility of increased disease transmission were few problems in the implementation of DOTS during the lockdown. AIM: To assess effect of pandemic on DOTS treatment during COVID-19 lockdown. METHODS: A cross-sectional study was conducted among 254 tuberculosis patients who were under DOTS during Covid-19 lockdown in Belagavi district. Participants who were on DOTS during 2019-2021 period. RESULT: Of 254 participants, only 5 (2.0%) were supervised while taking drugs, 67 (26.4%) of subject's empty blister packs were taken back by health personnel and 106 (41.7%) participants were regularly followed up for treatment by health department. The variables like gender, literacy status, socioeconomic status, and occupation were all significantly associated with hampered access to DOTS during the lockdown period at p < 0.05. CONCLUSION: This study concluded that the participants had hampered accessibilities to DOTS during lockdown.