title: Survey of health care worker knowledge about childhood tuberculosis in high-burden centers in Botswana.
abstract: Quantifying health care workers' (HCWs') knowledge about tuberculosis (TB) informs educational interventions. We assessed HCWs' knowledge about childhood TB in Botswana.
  
  
  
  Semi-structured interviews were conducted with HCWs at 46 sites around Botswana using a piloted instrument. Transcripts were double-coded using a coding schema. Discrepancies were resolved by consensus and a systematic thematic analysis was performed.
  
  
  
  The sites (42 clinics and 4 hospitals) were urban (n = 9, 20%), semi-urban (n = 10, 22%) and rural (n = 27, 58%). HCWs included nurses (n = 42, 89%) and nurse assistants (n = 4, 11%). Sixteen (56%) HCWs were the TB focal persons for their site. Themes did not vary by type of site, HCW or TB focal person. Although the level of knowledge about secondary prevention using isoniazid prophylaxis therapy was fair, implementation was poor and contact tracing was not being performed. Barriers to TB diagnosis included poor knowledge about TB in the community, minimal diagnostics at site of care and not receiving test results. However, most HCWs reported that treatment initiation and the calculation of appropriate dosages were easy once the diagnosis had been made.
  
  
  
  In Botswana, HCWs' levels of knowledge about childhood TB varied greatly. The areas of TB diagnosis, screening and prophylaxis in children need additional attention in TB training courses; however, increased knowledge alone would not overcome all the barriers identified by the HCWs.
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania, USA, Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, Botswana-UPenn Partnership, Gaborone.
authors.forename: T
authors.initials: T
authors.lastname: Arscott-Mills
authors.affiliation: Botswana-UPenn Partnership, Gaborone.
authors.forename: L
authors.initials: L
authors.lastname: Masole
authors.affiliation: Botswana's National TB Program, Ministry of Health, Gaborone, Botswana, International Union Against Tuberculosis and Lung Disease, Harare, Zimbabwe.
authors.forename: R
authors.initials: R
authors.lastname: Ncube
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania, USA, Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, Botswana-UPenn Partnership, Gaborone.
authors.forename: A P
authors.initials: AP
authors.lastname: Steenhoff
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage*; D001902:Botswana; D002648:Child; D016358:Contact Tracing / Q000379:methods; D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D007538:Isoniazid / Q000008:administration & dosage; D008403:Mass Screening / Q000379:methods; D010865:Pilot Projects; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000175:diagnosis / Q000517:prevention & control; D019037:Urban Health Services
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid