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Review

Provision of Decentralized TB Care Services: A Detect–Treat–Prevent Strategy for Children and Adolescents Affected by TB

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The Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala P.O. Box 22418, Uganda
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Médecins Sans Frontières, Cape Town 7784, South Africa
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Socios En Salud Sucursal Perú, Lima 15001, Peru
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Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru
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Interactive Research and Development Global, Singapore 238884, Singapore
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Elizabeth Glaser Pediatric AIDS Foundation, Kinshasa B.P. 1002030, Democratic Republic of the Congo
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United Nations Children’s Fund, New York, NY 10017, USA
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Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Adrie J.C. Steyn
Pathogens 2021, 10(12), 1568; https://doi.org/10.3390/pathogens10121568
Received: 1 November 2021 / Revised: 23 November 2021 / Accepted: 25 November 2021 / Published: 1 December 2021
In this review, we discuss considerations and successful models for providing decentralized diagnosis, treatment, and prevention services for children and adolescents. Key approaches to building decentralized capacity for childhood TB diagnosis in primary care facilities include provider training and increased access to child-focused diagnostic tools and techniques. Treatment of TB disease should be managed close to where patients live; pediatric formulations of both first- and second-line drugs should be widely available; and any hospitalization should be for as brief a period as medically indicated. TB preventive treatment for child and adolescent contacts must be greatly expanded, which will require home visits to identify contacts, building capacity to rule out TB, and adoption of shorter preventive regimens. Decentralization of TB services should involve the private sector, with collaborations outside the TB program in order to reach children and adolescents where they first enter the health care system. The impact of decentralization will be maximized if programs are family-centered and designed around responding to the needs of children and adolescents affected by TB, as well as their families. View Full-Text
Keywords: tuberculosis; decentralization; primary health care; patient-centered care; children; adolescents tuberculosis; decentralization; primary health care; patient-centered care; children; adolescents
MDPI and ACS Style

Zawedde-Muyanja, S.; Reuter, A.; Tovar, M.A.; Hussain, H.; Loando Mboyo, A.; Detjen, A.K.; Yuen, C.M. Provision of Decentralized TB Care Services: A Detect–Treat–Prevent Strategy for Children and Adolescents Affected by TB. Pathogens 2021, 10, 1568. https://doi.org/10.3390/pathogens10121568

AMA Style

Zawedde-Muyanja S, Reuter A, Tovar MA, Hussain H, Loando Mboyo A, Detjen AK, Yuen CM. Provision of Decentralized TB Care Services: A Detect–Treat–Prevent Strategy for Children and Adolescents Affected by TB. Pathogens. 2021; 10(12):1568. https://doi.org/10.3390/pathogens10121568

Chicago/Turabian Style

Zawedde-Muyanja, Stella, Anja Reuter, Marco A. Tovar, Hamidah Hussain, Aime Loando Mboyo, Anne K. Detjen, and Courtney M. Yuen. 2021. "Provision of Decentralized TB Care Services: A Detect–Treat–Prevent Strategy for Children and Adolescents Affected by TB" Pathogens 10, no. 12: 1568. https://doi.org/10.3390/pathogens10121568

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