title: Ending neglect: providing effective childhood tuberculosis training for health care workers in Tanzania.
abstract: METHODS
  Health care facilities in Dar es Salaam, Pwani, and Arusha, Tanzania.
  
  
  OBJECTIVE
  To assess health care worker (HCW) knowledge and practices 1 year after specialized training in childhood tuberculosis (TB).
  
  
  METHODS
  Using a standardized survey, we interviewed a convenience sample of HCWs providing both general and specialized care to children.
  
  
  RESULTS
  We interviewed 117 HCWs in TB clinics, maternal and child health clinics, human immunodeficiency virus (HIV) clinics, out-patient departments, and pediatric in-patient wards at 12 facilities. A total of 81 HCWs (62% of nurses, 74% of clinicians) reported having attended the national childhood TB training course. Most HCWs responded correctly to questions on childhood TB diagnosis, treatment, and TB-HIV co-management, regardless of training history. Most HCWs reported that they routinely obtain chest radiographs, HIV testing, and a TB contact history when evaluating children for TB. Less than half of HCWs reported routinely obtaining sputum for mycobacterial culture or performing a tuberculin skin test. Three times as many trained as untrained HCWs reported having ever prescribed isoniazid preventive therapy (IPT) to a child (P < 0.05).
  
  
  CONCLUSIONS
  In general, levels of childhood TB knowledge were high and practices were in accordance with national guidance. Specific gaps in diagnosis, treatment and use of IPT were identified for future focused training.
authors.affiliation: Infectious Disease and International Health Section, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
authors.forename: L V
authors.initials: LV
authors.lastname: Adams
authors.affiliation: National Tuberculosis and Leprosy Control Programme, Dar es Salaam, Tanzania.
authors.forename: R
authors.initials: R
authors.lastname: Olotu
authors.affiliation: Infectious Disease and International Health Section, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Talbot
authors.affiliation: Dartmouth College, Hanover, New Hampshire, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Cronin
authors.affiliation: National Tuberculosis and Leprosy Control Programme, Dar es Salaam, Tanzania.
authors.forename: R
authors.initials: R
authors.lastname: Christopher
authors.affiliation: Tuberculosis & Human Immunodeficiency Virus (TB-HIV) Unit, Program for Appropriate Technology in Health (PATH), Dar es Salaam, Tanzania.
authors.forename: Z
authors.initials: Z
authors.lastname: Mkomwa
keywords: HIV; Tanzania; evaluation; pediatrics; tuberculosis