A qualitative study of patient, caregiver, doctor and nurse views of factors influencing lumbar puncture uptake in Zambia.

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dc.contributor.affiliationDepartment of Internal Medicine, University of Zambia School of Medicine, Lusaka, 10101, Zambia.
dc.contributor.affiliationDepartment of Neurology, University of Michigan, Ann Arbor, MI 48105, USA.
dc.contributor.affiliationUniversity Teaching Hospitals, Children's Hospital, Lusaka, 10101, Zambia.
dc.contributor.affiliationCamden and Islington NHS Foundation Trust, London, NW1 OPE, UK.
dc.contributor.affiliationDepartment of Neurology, University of Rochester, Rochester, NY 14642, USA.
dc.contributor.affiliationDepartment of Psychiatry, University College London, London, W1T 7BN, UK.
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia, Lusaka, 10101, Zambia.
dc.contributor.affiliationZambart, School of Public Health, University of Zambia, Lusaka, 10101, Zambia.
dc.contributor.affiliationDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
dc.contributor.affiliationCIDRZ
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia (CIDRZ)
dc.contributor.authorElafros MA
dc.contributor.authorBelessiotis-Richards C
dc.contributor.authorBirbeck GL
dc.contributor.authorBond V
dc.contributor.authorSikazwe I
dc.contributor.authorKvalsund MP
dc.date.accessioned2025-05-23T11:40:57Z
dc.date.issued2022-Apr-04
dc.description.abstractBACKGROUND: Uptake of lumbar puncture (LP) remains low in regions with a high prevalence of central nervous system (CNS) infections like Zambia. Efforts to improve uptake are hindered by limited understanding of factors influencing LP uptake. METHODS: Semistructured qualitative interviews were conducted with patients with suspected CNS infection, caregivers, doctors and nurses at the University Teaching Hospitals in 2016. Questions focused on LP experiences, knowledge, the consent process and health system barriers to LP among patients with an LP indication. Interviews were transcribed, translated to English and analysed using a thematic approach. RESULTS: We recruited 24 adult patients, 36 caregivers of adult patients, 63 caregivers of paediatric patients, 20 doctors and 30 nurses (173 in total). LP barriers arose from both patients/caregivers and health providers and included community apprehension about LP, proxy (family) consensus consent practices, competing clinical demands, wariness of patient/caregiver responses, limitations in consumables and time to complete the LP. This could result in consent not being obtained correctly. LP enablers included patient/caregiver perceived LP utility, provider comfort with LP and in-person counselling. CONCLUSIONS: LP uptake is a complex sociocultural process influenced by patient, healthcare and community-level factors. Interventions to improve uptake must address multiple barriers to be successful.
dc.identifier.doi10.1093/trstmh/trab124
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/10353
dc.sourceTransactions of the Royal Society of Tropical Medicine and Hygiene
dc.titleA qualitative study of patient, caregiver, doctor and nurse views of factors influencing lumbar puncture uptake in Zambia.

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