ABSTRACT
SETTING: We conducted a qualitative exploration into the palatability and acceptability of a novel fixed-dose combination (FDC) anti-tuberculosis drug. This study was nested in the SHINE (Shorter treatment for minimal TB in children) trial, which compares the safety and efficacy of treating non-severe drug-susceptible tuberculosis (TB) with a 6 vs. 4 months anti-tuberculosis regimen in children aged 0-16 years. Participants were recruited in Cape Town, South Africa.OBJECTIVE: To describe the palatability and acceptability of a FDC of rifampicin, isoniazid and pyrazinamide among South African children and their caregivers in the SHINE trial.METHODS: We conducted 20 clinic observations of treatment administration, during which we conducted 16 semi-structured interviews with children and their caregivers. Data were organised thematically to report on experiences with administering and ingesting the FDC.RESULTS: Children and caregivers' experiences varied from delight to disgust. In general, participants said that the FDC compared favourably to other formulations. Pragmatic challenges such as dissolving the FDC and the time required to administer the FDC impeded caregivers' ability to integrate treatment into their daily routines. Drug manipulation was common among caregivers to improve TB treatment administration.CONCLUSION: This novel FDC appears acceptable for children, albeit with practical challenges to administration. Scale-up of FDC use should include supplementary intervention components to support caregivers.
Subject(s)
Antitubercular Agents/therapeutic use , Patient Satisfaction , Tuberculosis, Pulmonary/drug therapy , Administration, Oral , Adolescent , Antitubercular Agents/administration & dosage , Case-Control Studies , Child , Child Health Services , Child, Preschool , Drug Administration Schedule , Female , Humans , Infant , Infant, Newborn , Interviews as Topic , Male , South AfricaABSTRACT
Individuals' perceptions of risk have implications for whether and how they engage with protective strategies. This study investigated how sexual risk; specifically HIV and pregnancy and responsibility for these risks were constructed in discussions across five groups of youth in KwaZulu-Natal; South Africa. The qualitative study used focus groups and interviews with a sample of 28 tertiary level students and 7 peri-urban youth. The constructions of risk intersected with raced and gendered narratives around sexual risk and responsibility. These constructions were used by the participants to assign and displace responsibility for the risks of HIV and pregnancy; rendering some groups immune to these risks. This constitutes a form of stigmatisation and also has implications for participants' prevention practices
Subject(s)
Pregnancy, Unplanned/ethnology , Pregnancy, Unplanned/psychology , Risk-Taking , Sexual Behavior/psychology , Social Responsibility , South Africa , StudentsABSTRACT
OBJECTIVE: To assess attitudinal and behavioral symptoms of eating disorders in preadolescent and adolescent girls with IDDM and a matched sample of nondiabetic subjects, and to explore the relationship between the perceived impact of IDDM and eating disorder symptoms. RESEARCH DESIGN AND METHODS: All eligible IDDM patients (girls, age 8-18 yr) from the case register of the Yale Children's Diabetes Clinic were recruited for this study. Of 49 eligible patients, 46 participated in the study. Control subjects were recruited among students in several local schools; 46 girls, individually age and race-matched with IDDM patients, and group-matched by father's socioeconomic status, were included in this study. All subjects participated in an investigator-based clinical interview (EDE) and completed a self-report measure of eating-related psychopathology (EDI). IDDM subjects completed the DQOL measure to determine the perceived impact of diabetes on patients' lives. RESULTS: IDDM patients reported significantly more regular consumption of meals and snacks than did nondiabetic subjects. No group differences were found on measures of symptoms of eating disorders: both groups reported minimal levels of symptoms. Among adolescent IDDM patients, eating disorder symptoms were related significantly to patients' dissatisfaction with the illness and its impact on their lives. CONCLUSIONS: It appears that when applying stringent diagnostic procedures and matching criteria, IDDM girls do not evidence an elevated prevalence of eating disorder symptoms. However, those IDDM patients who did report symptoms may be a high-risk group for the development of an eating disorder and should be followed prospectively.
