Tuberculosis care models for children and adolescents: a scoping review.
Bull World Health Organ
; 100(12): 777-788L, 2022 Dec 01.
Article
in En
| MEDLINE
| ID: mdl-36466210
ABSTRACT
Objective:
To map which tuberculosis care models are best suited for children and adolescents.Methods:
We conducted a scoping review to assess the impact of decentralized, integrated and family-centred care on child and adolescent tuberculosis-related outcomes, describe approaches for these care models and identify key knowledge gaps. We searched seven literature databases on 5 February 2021 (updated 16 February 2022), searched the references of 18 published reviews and requested data from ongoing studies. We included studies from countries with a high tuberculosis burden that used a care model of interest and reported tuberculosis diagnostic, treatment or prevention outcomes for an age group < 20 years old.Findings:
We identified 28 studies with a comparator group for the impact assessment and added 19 non-comparative studies to a qualitative analysis of care delivery approaches. Approaches included strengthening capacity in primary-level facilities, providing services in communities, screening for tuberculosis in other health services, co-locating tuberculosis and human immunodeficiency virus treatment, offering a choice of treatment location and providing social or economic support. Strengthening both decentralized diagnostic services and community linkages led to one-to-sevenfold increases in case detection across nine studies and improved prevention outcomes. We identified only five comparative studies on integrated or family-centred care, but 11 non-comparative studies reported successful treatment outcomes for at least 71% of children and adolescents.Conclusion:
Strengthening decentralized services in facilities and communities can improve tuberculosis outcomes for children and adolescents. Further research is needed to identify optimal integrated and family-centred care approaches.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tuberculosis
Type of study:
Diagnostic_studies
/
Prognostic_studies
/
Qualitative_research
/
Systematic_reviews
Limits:
Adolescent
/
Adult
/
Child
/
Humans
Language:
En
Journal:
Bull World Health Organ
Year:
2022
Document type:
Article