International Journal of Public Health and Epidemiology

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (5), pp. 001-014, May, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Barriers and facilitators to childhood tuberculosis detection in Marondera District, Mashonaland East Province, Zimbabwe

Lawrence Mutewuki¹, Abigail Kapfunde², Paul Farai Matsvimbo³, and Eltony Mugomeri^4
 
1Public Health Officer, Department of Public Health and Nursing, Africa University, Mutare, Zimbabwe.
²Senior Lecturer, Maternal and Child Health-Department of Public Health and Nursing, Africa University, Mutare, Zimbabwe. ³MD-Provincial Medical Director, Mashonaland East Province, Ministry of Health and Child Care, Marondera, Zimbabwe. ⁴Associate Professor and Interim Director, Office of Research and Innovation, Africa University, Mutare, Zimbabwe.

Abstract

Received 16 February, 2026; Revised 25 March, 2026; Accepted 26 March, 2026; Published 31 May, 2026

Background: Tuberculosis (TB) remains a significant public health threat, particularly in children in low health resource settings. Despite national efforts in Zimbabwe, childhood TB case detection in Marondera District, Zimbabwe is still below 12.0% of the national target of TB notifications. The study investigated the factors associated with childhood TB case detection in Marondera District. Methods:  An analytic cross- sectional study was conducted between July and November 2025 to identify barriers and facilitators to childhood TB case detection. Structured questionnaires were administered to healthcare workers and community healthcare workers. Data were analyzed using univariate and multivariate regression in Stata 19, with statistical significance defined as p<0.050. Adjusted Odds Ratio (AOR) was used to interpret facilitators and barriers to TB case detection. Results: Key facilitators for case detection were competence in TB screening (AOR= 1.9; C.I=1.4-2.5; p=<0.001), prior contact with childhood TB (AOR=1.3; 95% C.I=1.1-1.5; p=<0.001), and TB co-infection (AOR=1.3; 95% C.I=1.1-1.5; p=<0.001). Caregiver social support (AOR=1.4; 95% C.I=1.2-1.7; p=0.002), Health education (AOR=1.8; 95% C.I=1.3-2.5; p=0.005), and community awareness (AOR=1.3; 95% C.I=1.1-1.6; p=0.033) also promoted healthcare seeking. Barriers included cultural beliefs (AOR=0.6; 95% C.I=0.5-0.8; p=0.005), lack of awareness (AOR=2.3; 95% C.I=1.6-3.3; p=<0.001), and geographical barriers (AOR=0.6; 95% C.I=0.5-0.8; p=0.002). Conclusion: Improving childhood TB case detection in low health resource settings requires strengthening healthcare workers’ clinical capacity and enhancing community-level awareness and support. Targeted interventions addressing socioeconomic and access-related barriers are essential to reduce morbidity and mortality among children.

Keywords: Barriers to TB detection; Community awareness to TB detection; TB Detection Competence; Facilitators for TB detection; TB in low health resource settings.