{"doi":"10.4269/ajtmh.22-0798","title":"Duration of Symptoms Prior to Pediatric and Adolescent Tuberculosis Diagnosis and Its Impact on Schooling in Tanzania: A Mixed Methods Study","abstract":"At least a third of tuberculosis (TB) cases remain undiagnosed, disproportionately so in children and adolescents, which is hampering global elimination goals. Prolonged symptom duration presents a high-risk scenario for childhood TB in endemic areas, but the prolonged period of symptoms and its impact on educational attainment are rarely documented. Using a mixed method approach, we aimed to quantify the duration of respiratory symptoms and describe their impact on education among children from a rural area of Tanzania. We used data from a prospectively enrolled cohort of children and adolescents aged 4-17 years in rural Tanzania at the start of active TB treatment. We report on the cohort's baseline characteristics and explore the correlation between duration of symptoms and other variables. In-depth qualitative interviews were designed on the basis of a grounded theory approach to explore the impact of TB on educational attainment among school-aged children. In this cohort, children and adolescents diagnosed with TB experienced symptoms for a median of 85 days (interquartile range: 30, 231 days) prior to treatment initiation. In addition, 56 participants (65%) had a TB exposure in the household. Of the 16 families with school-aged children who were interviewed, 15 (94%) reported a significant negative impact of TB on the schooling of their children. Children in this cohort experienced a long duration of TB symptoms; the extent of illness impacted absenteeism at school. Screening initiatives for households affected by TB may lead to a shortened duration of symptoms and may minimize the impact on school attendance.","journal":"American Journal of Tropical Medicine and Hygiene","year":2023,"id":386130,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9578,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1100874,"name":"Saning’o Lukumay","orcid":null,"position":1,"is_corresponding":false},{"id":1100870,"name":"Domitila Augustino","orcid":null,"position":2,"is_corresponding":false},{"id":1100871,"name":"Paulo Mejan","orcid":null,"position":3,"is_corresponding":false},{"id":1154760,"name":"Rehema Bukhay","orcid":null,"position":4,"is_corresponding":false},{"id":365914,"name":"Museveni Justine","orcid":null,"position":5,"is_corresponding":false},{"id":1100873,"name":"Cornel Massong","orcid":null,"position":6,"is_corresponding":false},{"id":365913,"name":"Prakruti Rao","orcid":null,"position":7,"is_corresponding":false},{"id":375102,"name":"Kristen Petros de Guex","orcid":null,"position":8,"is_corresponding":false},{"id":423414,"name":"Herman Pfaeffle","orcid":null,"position":9,"is_corresponding":false},{"id":257482,"name":"Estomih Mduma","orcid":"0000-0002-9401-3982","position":10,"is_corresponding":false},{"id":365124,"name":"Christopher Vinnard","orcid":"0000-0002-0641-7814","position":11,"is_corresponding":false},{"id":584800,"name":"Yingda L. Xie","orcid":"0000-0001-5587-4731","position":12,"is_corresponding":false},{"id":365125,"name":"Scott K. Heysell","orcid":"0000-0002-2040-0293","position":13,"is_corresponding":false},{"id":365123,"name":"Tania A. Thomas","orcid":"0000-0002-3929-6369","position":14,"is_corresponding":false},{"id":1154427,"name":"Ghassan Ilaiwy","orcid":"0000-0001-6769-3217","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:17:56.803401Z","pmid":"37094782","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}