Tuberculosis diagnosis and treatment of young South African children: experiences and perceptions of care-givers

Abstract

Setting: Tuberculosis (TB) in infants and young children is a major public health concern in South Africa. As care-givers of young children often supervise TB treatment, we explored their experiences and perceptions of TB. Objectives: To ascertain TB awareness, feelings about and problems with the treatment and perceptions of TB health education among care-givers of young children being treated for TB. Design: An interview schedule with closed and open-ended items was designed to obtain care-giver information on background details, TB awareness, feelings and problems with the treatment, and perceptions of TB health education. Two trained interviewers administered the schedule. Responses were analysed descriptively. Responses to open-ended items were grouped into common themes and given conceptual labels. Results: 51 care-givers (36 black, 11 coloured and 4 white) were interviewed. Only 8 suspected that their children had TB, but 23 sought medical attention for the classic signs/symptoms of TB. The majority had positive feelings about the treatment and felt relief/happiness due to improvement in the child's physical health. The major problems with TB therapy were the child's refusal to take the medication and distance to the clinic. Out of the 41 care-givers who acted as supervisors of TB treatment, 9 had received TB health education at a clinic, usually once, through a talk. The most important parts were giving the child treatment as prescribed and signs/symptoms of TB. Conclusions: Care-givers had a low level of TB awareness, but were very concerned about their children's health. There is a vast discrepancy between system and care-giver perspectives on TB health education, requiring immediate and radical action.