Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania
Frontiers
Na minha lista:
| Main Authors: | , , |
|---|---|
| Formato: | Artigo |
| Idioma: | en_US |
| Publicado em: |
Frontiers Public Health
2025
|
| Assuntos: | |
| Acesso em linha: | https://scholar.mzumbe.ac.tz/handle/123456789/1900 |
| Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
| _version_ | 1872791444787298304 |
|---|---|
| author | Shilugu,Lucas L. Mushi, Lawrencia D. Anasel, Mackfallen G. |
| author_facet | Shilugu,Lucas L. Mushi, Lawrencia D. Anasel, Mackfallen G. |
| author_sort | Shilugu,Lucas L. |
| collection | DSpace |
| description | Frontiers |
| format | Article |
| id | ir-:123456789-1900 |
| institution | Mzumbe University |
| language | en_US |
| publishDate | 2025 |
| publisher | Frontiers Public Health |
| record_format | dspace |
| spelling | ir-:123456789-19002026-06-24T18:47:49Z Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania a cross-sectional evaluation Shilugu,Lucas L. Mushi, Lawrencia D. Anasel, Mackfallen G. tuberculosis TBHIV screening algorithm fidelity evaluation Frontiers Tuberculosis (TB) remains the leading cause of morbidity and mortality among people living with HIV (PLHIV) in high-burden countries like Tanzania. Despite national and global guidelines recommending routine TB screening at every clinical encounter, missed and delayed TB case notifications persist, suggesting gaps in screening practices. This study evaluated the implementation fidelity of the TB screening algorithm and associated factors within routine HIV care in public health facilities in Geita, Tanzania. A facility-based cross-sectional study was conducted, involving the extraction of data from 423 client treatment records and observation of 423 screening sessions. Simple random and systematic sampling methods were employed to select the records and sessions, respectively. Descriptive and inferential analyses were performed using Excel and Stata. Modified Poisson regression with robust variance was used to estimate prevalence ratios (PRs) to determine factors associated with two binary outcomes: (1) consistent TB screening over 12-month period, and (2) correct utilization of the screening tool. TB screening was documented in 82.8% of clinical encounters. Overall, 70.7% of clients were screened at every encounter, and 75.4% screened at their most recent visit. Laboratory investigations were recorded in 94% of presumptive cases, with all confirmed TB cases initiated on treatment. Additionally, 80.6% of eligible clients were initiated on TB preventive therapy (TPT). The WHO Four-Symptom Screening (W4SS) was widely used (98.8%), and the tool was correctly administered in 62% of the sessions observed. Factors associated with inconsistent screening included age 40–49 years [Adjusted Prevalence Ratio (aPR) = 0.82; p = 0.046], age ≥50 years (aPR = 0.76; p = 0.025), suppressed viral load (aPR = 0.63; p < 0.001), monthly drug refill model (aPR = 0.55; p = 0.006), refill by treatment supporter (aPR = 0.09; p < 0.001), being traced back from a lost to follow up (aPR = 1.38; p = 0.019), and absence of prior TB (aPR = 0.81; p = 0.001). The correct use of the W4SS tool was less likely at PMTCT clinics (aPR = 0.55; p < 0.001). Although TB screening is widely integrated into HIV care, fidelity to the screening algorithm remains suboptimal in the initial stages of symptom screening. The completion of the algorithm cascade was well-implemented. Fidelity at earlier stages of the algorithm, such as the consistent and correct use of the W4SS, should be enhanced by strengthening provider capacity and routine monitoring to improve adherence to the protocol. Frontiers 2025-11-19T13:11:18Z 2025-11-19 Article APA 10.3389/fpubh.2025.1688829 https://scholar.mzumbe.ac.tz/handle/123456789/1900 en_US application/pdf Frontiers Public Health |
| spellingShingle | tuberculosis TBHIV screening algorithm fidelity evaluation Shilugu,Lucas L. Mushi, Lawrencia D. Anasel, Mackfallen G. Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania |
| title | Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania |
| title_full | Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania |
| title_fullStr | Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania |
| title_full_unstemmed | Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania |
| title_short | Provider fidelity in tuberculosis screening practices among adolescents and adults living with HIV in public health facilities in Tanzania |
| title_sort | provider fidelity in tuberculosis screening practices among adolescents and adults living with hiv in public health facilities in tanzania |
| topic | tuberculosis TBHIV screening algorithm fidelity evaluation |
| url | https://scholar.mzumbe.ac.tz/handle/123456789/1900 |
| work_keys_str_mv | AT shilugulucasl providerfidelityintuberculosisscreeningpracticesamongadolescentsandadultslivingwithhivinpublichealthfacilitiesintanzania AT mushilawrenciad providerfidelityintuberculosisscreeningpracticesamongadolescentsandadultslivingwithhivinpublichealthfacilitiesintanzania AT anaselmackfalleng providerfidelityintuberculosisscreeningpracticesamongadolescentsandadultslivingwithhivinpublichealthfacilitiesintanzania AT shilugulucasl acrosssectionalevaluation AT mushilawrenciad acrosssectionalevaluation AT anaselmackfalleng acrosssectionalevaluation |