Towards quality adolescent-friendly services in TB care

Laycock, Katherine M.; Eby, Jessica; Arscott-Mills, Tonya; Argabright, Stirling T.; Caiphus, Cynthia; Kgwaadira, Botshelo; Lowenthal, Elizabeth; Steenhoff, Andrew P.; Enane, Leslie A.

doi:10.5588/ijtld.21.0059

Cited by 6 publications

(13 citation statements)

References 14 publications

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“…Common reasons for a lack of family support include poor caregiver understanding about TB, severe poverty, family conflict or neglect, and older AYAs moving away from home [52]. AYAs are particularly sensitive to stigma, which is a central driver of adolescent disengagement from TB care [52,53]. Facility-based DOT exacerbates this barrier to adherence, as AYAs fear neighbors will see them receiving TB treatment.…”

Section: Tb Treatment Outcomes and Adherencementioning

confidence: 99%

The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults

et al. 2021

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The health needs of adolescents and young adults (AYAs) have been neglected in tuberculosis (TB) care, control, and research. AYAs, who are distinct from younger children and older adults, undergo dynamic physical, psychological, emotional, cognitive, and social development. Five domains of adolescent well-being are crucial to a successful transition between childhood and adulthood: (1) Good health; (2) connectedness and contribution to society; (3) safety and a supportive environment; (4) learning, competence, education, skills, and employability; and (5) agency and resilience. This review summarizes the evidence of the impact of TB disease and treatment on these five domains of AYA well-being.

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Section: Tb Treatment Outcomes and Adherencementioning

confidence: 99%

The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults

et al. 2021

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“…For AYA with TB disease, treatment requires prolonged adherence to multiple medications. These treatment regimens, while identical to those used for adults with TB disease, can create unique adherence challenges for AYA and should be provided as part of comprehensive services tailored to AYA needs [3,[22][23][24]. Approaches to treatment of TB disease for AYA are beginning to be defined and are considered in detail elsewhere [3].…”

Section: Tb Disease Treatment For Ayamentioning

confidence: 99%

“…Approaches to treatment of TB disease for AYA are beginning to be defined and are considered in detail elsewhere [3]. To date, global TB programs have not implemented adolescent-friendly TB services or adolescent-specific strategies to support adolescents in the completion of TPT or treatment of TB disease [22,23]. Research and dedicated implementation strategies for adolescent TB treatment are urgently needed.…”

Section: Tb Disease Treatment For Ayamentioning

confidence: 99%

“…Ongoing efforts aim to identify the AYA at highest risk for TB through the development and validation of individualized risk scores that incorporate epidemiologic and personal risk factors [108]. Opportunities to support AYA receiving treatment for TB disease, which have been described elsewhere, also need urgent attention [22,23].…”

Section: Identifying Aya With Tbmentioning

confidence: 99%

“…Investigators of an outbreak that occurred at a school in China just before national examinations noted that students' reluctance to interrupt their studies to seek care allowed infections to spread further [85]. Similarly, AYA with TB disease in Botswana expressed unwillingness to leave school or work in order to receive treatment [23]. Access to earlier active case-finding and TPT might prevent such disruptions related to TB disease management, and school-based options for the provision of both TPT and TB treatment should be evaluated further.…”

Section: Schoolsmentioning

confidence: 99%

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Tuberculosis in Adolescents and Young Adults: Emerging Data on TB Transmission and Prevention among Vulnerable Young People

2021

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Adolescents and young adults (AYA, ages 10–24 years) comprise a uniquely important but understudied population in global efforts to end tuberculosis (TB), the leading infectious cause of death by a single agent worldwide prior to the COVID-19 pandemic. While TB prevention and care strategies often overlook AYA by grouping them with either children or adults, AYA have particular physiologic, developmental, and social characteristics that require dedicated approaches. This review describes current evidence on the prevention and control of TB among AYA, including approaches to TB screening, dynamics of TB transmission among AYA, and management challenges within the context of unique developmental needs. Challenges are considered for vulnerable groups of AYA such as migrants and refugees; AYA experiencing homelessness, incarceration, or substance use; and AYA living with HIV. We outline areas for needed research and implementation strategies to address TB among AYA globally.

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