Integrating pediatric TB services into child healthcare services in Africa: study protocol for the INPUT cluster-randomized stepped wedge trial

Autor: Lise Denoeud-Ndam, Rose Otieno-Masaba, Boris Tchounga, Rhoderick Machekano, Leonie Simo, Joseph Phelix Mboya, Judith Kose, Patrice Tchendjou, Anne-Cécile Zoung-Kanyi Bissek, Gordon Odhiambo Okomo, Martina Casenghi, Jennifer Cohn, Appolinaire Tiam, the INPUT Study Group
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BMC Public Health, Vol 20, Iss 1, Pp 1-12 (2020)
Druh dokumentu: article
ISSN: 1471-2458
DOI: 10.1186/s12889-020-08741-2
Popis: Abstract Background Tuberculosis is among the top-10 causes of mortality in children with more than 1 million children suffering from TB disease annually worldwide. The main challenge in young children is the difficulty in establishing an accurate diagnosis of active TB. The INPUT study is a stepped-wedge cluster-randomized intervention study aiming to assess the effectiveness of integrating TB services into child healthcare services on TB diagnosis capacities in children under 5 years of age. Methods Two strategies will be compared: i) The standard of care, offering pediatric TB services based on national standard of care; ii) The intervention, with pediatric TB services integrated into child healthcare services: it consists of a package of training, supportive supervision, job aids, and logistical support to the integration of TB screening and diagnosis activities into pediatric services. The design is a cluster-randomized stepped-wedge of 12 study clusters in Cameroon and Kenya. The sites start enrolling participants under standard-of-care and will transition to the intervention at randomly assigned time points. We enroll children aged less than 5 years with a presumptive diagnosis of TB after obtaining caregiver written informed consent. The participants are followed through TB diagnosis and treatment, with clinical information prospectively abstracted from their medical records. The primary outcome is the proportion of TB cases diagnosed among children
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