ArticlePublic health action2025
A qualitative study of home- versus facility-based TB treatment for adolescents in Lima, Peru.
Article in Public health action, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundPrior to the COVID-19 pandemic, TB treatment in Peru was delivered almost exclusively through facility-based directly observed therapy (DOT). During the pandemic, selected adolescents were allowed home-based TB treatment under caregiver supervision, along with video-supported treatment (VST) for adolescents with access to a smartphone.
methodsWe conducted 16 focus groups, each with 4-10 participants of adolescents with rifampicin-susceptible TB, their caregivers, and health care workers (HCWs). We used semi-structured guides to gather perspectives on facility-based DOT versus home-based treatment. Two authors applied inductive thematic analysis and identified emerging themes.
resultsHCWs assigned facility-based DOT or home-based treatment based on subjective assessment of the adolescent's level of responsibility and support from caregivers. Almost all adolescents and caregivers preferred home-based treatment because it reduced disruptions to routine activities, TB-related stigma, and costs. A few disagreed, stating that facility-based DOT was better for guaranteeing adherence and support for adverse drug reactions. Most HCWs preferred facility-based DOT because they did not feel confident about adherence without direct visualisation by a provider, even with VST; moreover, they found VST to be time-consuming.
conclusionHome-based TB treatment benefits adolescents and caregivers but must be further modified to achieve feasibility and acceptability among HCWs.
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