Evidence map›Paper›PMID 36681840›Full record

ArticlePediatric rheumatology online journal2023

An iceberg I can't handle: a qualitative inquiry on perceptions towards paediatric rheumatology among healthcare workers in Kenya.

Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen E Foster, Peter Muriuki, Adelaide Lusambili, Stanley Luchters

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric rheumatology online journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. The inequity of global healthcare in pediatric rheumatology.Best practice & research. Clinical rheumatology · 2024
    Review
  6. Observational
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Angela MigowaInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. angela.migowa@aku.edu.ORCID http://orcid.org/0000-0002-1146-7963
Sasha BernatskyDepartment of Medicine (Division of Rheumatology and Epidemiology) McGill University Health Centre (MUCH), Montreal, Canada.
Anthony NgugiDepartment of Population Health, Aga Khan University East Africa, Nairobi, Kenya.
Helen E FosterPopulation and Health Institute, Newcastle University, Newcastle, UK.
Peter MuriukiAfrican Population and Health Research Centre, Nairobi, Kenya.
Adelaide LusambiliDepartment of Population Health, Aga Khan University East Africa, Nairobi, Kenya.
Stanley LuchtersInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.

Funding

University Research Council, Aga Khan University 211039
6 · The paper itself

Abstract

backgroundDelay in diagnosis and access to specialist care is a major problem for many children and young people with rheumatic disease in sub-Saharan Africa. Most children with symptoms of rheumatic disease present to non-specialists for care. There is an urgent need to understand and scale-up paediatric rheumatology knowledge and skills amongst non-specialist healthcare workers to promote early diagnosis, prompt referral, and management. PURPOSE: We evaluated the knowledge, attitudes and practices towards diagnosis and care of paediatric rheumatology patients among health care workers in Kenya.

methodsWe conducted 12 focus group discussions with clinical officers (third-tier community health workers) nurses, general practitioners and paediatricians across 6 regions in Kenya. Interviews were conducted on zoom, audio-recorded, transcribed, and analysed using NVIVO software.

resultsA total of 68 individuals participated; 11 clinical officers, 12 nurses, 10 general practitioners, 27 paediatricians and 7 others. Most (n = 53) were female, and the median age was 36 years (range 31-40 years). Fifty per cent of the participants (34 of 68) worked in public health facilities. Our study revealed gaps in knowledge of paediatric rheumatology amongst healthcare workers which contributes to delayed diagnosis and poor management. Healthcare workers reported both positive and negative attitudes towards diagnosis and care of paediatric rheumatology patients. Perceived complexity and lack of knowledge in diagnosis, management and lack of health system clinical pathways made all cadres of healthcare workers feel helpless, frustrated, inadequate and incompetent to manage paediatric rheumatology patients. Positive attitudes arose from a perceived feeling that paediatric rheumatology patients pose unique challenges and learning opportunities.

conclusionThere is an urgent need to educate healthcare workers and improve health systems to optimize clinical care for paediatric rheumatology patients.

Indexed as

Rheumatic DiseasesRheumatologyAdolescentAdultChildCommunity Health WorkersFemaleHumansKenyaMaleQualitative ResearchAttitudesHealth care workersKenyaKnowledgePaediatric rheumatologyPracticesSub-Saharan Africa

Identifiers

PMID36681840
PMCPMC9862847

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.