{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:29:33Z","timestamp":1789626573578,"version":"build-2803163510"},"reference-count":35,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R21AI138807"],"award-info":[{"award-number":["R21AI138807"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30-MH43520"],"award-info":[{"award-number":["P30-MH43520"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,9,2]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Isoniazid preventive therapy initiation and completion rates are suboptimal among children. Shorter tuberculosis (TB) preventive treatment (TPT) regimens have demonstrated safety and efficacy in children and may improve adherence but are not widely used in high TB burden countries. Understanding preferences regarding TPT regimens\u2019 characteristics and service delivery models is key to designing services to improve TPT initiation and completion rates. We examined paediatric TPT preferences in Eswatini, a high TB burden country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a sequential mixed-methods study utilising qualitative methods to inform the design of a discrete choice experiment (DCE) among HIV-positive children, caregivers and healthcare providers (HCP). Drug regimen and service delivery characteristics included pill size and formulation, dosing frequency, medication taste, treatment duration and visit frequency, visit cost, clinic wait time, and clinic operating hours. An unlabelled, binary choice design was used; data were analysed using fixed and mixed effects logistic regression models, with stratified models for children, caregivers and HCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in 20 healthcare facilities providing TB\/HIV care in Manzini, Eswatini, from November 2018 to December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Ninety-one stakeholders completed in-depth interviews to inform the DCE design; 150 children 10\u201314 years, 150 caregivers and 150 HCP completed the DCE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Despite some heterogeneity, the results were fairly consistent among participants, with palatability of medications viewed as the most important TPT attribute; fewer and smaller pills were also preferred. Additionally, shorter waiting times and cost of visit were found to be significant drivers of choices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Palatable medication, smaller\/fewer pills, low visit costs and shorter clinic wait times are important factors when designing TPT services for children and should be considered as new paediatric TPT regimens in Eswatini are rolled out. More research is needed to determine the extent to which preferences drive TPT initiation, adherence and completion rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048443","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T10:59:56Z","timestamp":1634900396000},"page":"e048443","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Paediatric tuberculosis preventive treatment preferences among HIV-positive children, caregivers and healthcare providers in Eswatini: a discrete choice experiment"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-1306","authenticated-orcid":false,"given":"Yael","family":"Hirsch-Moverman","sequence":"first","affiliation":[{"name":"ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Strauss","sequence":"additional","affiliation":[{"name":"Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"George","sequence":"additional","affiliation":[{"name":"Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Mutiti","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold","family":"Mafukidze","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siphesihle","family":"Shongwe","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria Sisi","family":"Dube","sequence":"additional","affiliation":[{"name":"Eswatini National TB Control Programme, Eswatini Ministry of Health, Mbabane, Hhohho, Swaziland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa M","family":"El Sadr","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne E","family":"Mantell","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Gender, Sexuality and Health Area, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A","family":"Howard","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, New York, USA"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"2025121511594111000_11.10.e048443.1","unstructured":"World Health Organization . 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