Assessing the acceptability of paclitaxel as treatment for Kaposi Sarcoma in patients and clinic providers in Mangochi

Kachedwa, Francis

Assessing the acceptability of paclitaxel as treatment for Kaposi Sarcoma in patients and clinic providers in Mangochi

Date

2022-07-11

Authors

Kachedwa, Francis

Publisher

Kamuzu University of Health Sciences

Abstract

Type of Study: This is a qualitative study that seeks to assess the acceptability of Paclitaxel as treatment for Kaposi Sarcoma in patients and clinic providers in Mangochi. Background of the problem: Kaposi Sarcoma patients in Malawi have long been treated with Vincristine either as a monotherapy or in combination with bleomycin. Given many reports of toxicity in vincristine patients at higher dosages albeit with little or no concomitant benefits of dosage increases, the government of Malawi revised the first line treatment for Kaposi Sarcoma. In this regard, the Malawi Ministry of Health (MOH), has embarked on rolling out Paclitaxel for Kaposi Sarcoma treatment to district hospitals, Mangochi inclusive, with only a few districts remaining. As this is a new intervention, there is a considerable knowledge gap as regards to patients’ and providers’ perceptions on Paclitaxel among other aspects. Such varying perceptions may have a significant bearing on the acceptability of Paclitaxel in the target population. Studies are therefore required especially in this preliminary stage of the intervention in order to unravel areas that require urgent addressing of quality issues among others. Therefore, in this regard, this study seeks to explore the acceptability of paclitaxel at the district hospital level of care. Objectives of the study: Broadly, the aim of the study is to assess the acceptability of paclitaxel as treatment for Kaposi Sarcoma (KS) among patients and providers in Mangochi district. The study seeks to specifically highlight perceptions of patients and providers on Paclitaxel usage and explore some pertinent barriers and enablers to acceptability of paclitaxel at a district hospital level of health care. Methodology: This is a qualitative study design that shall employ a phenomenological approach. The study will take place at Mangochi District Hospital in Mangochi District. The study population shall include of 32 participants comprising of 16 patients and 16 clinic providers selected through Non-probabilistic purposive sampling. Data will be collected through in-depth interviews using interview guides for both patients and providers. A focus group discussion will be conducted among providers for issues of maintaining patients privacy and confidentiality. The protocol shall be submitted for COMREC approval and approved written consents shall be administered or read to the participants to seek their consent. No names of participants shall be used in this study and the digital files and transcripts shall be stored under lock and key/ passwords with access limited to the research team. Data will be analysed manually using content analysis as guided by the Theoretical framework of acceptability. Dissemination of Expected findings: The study is expected to unravel any possible acceptability issues associated with Paclitaxel as treatment for Kaposi Sarcoma. The findings of this study will be shared to COMREC, COM library, Mangochi DHO, and at an annual dissemination conference organized by KUHeS, among other such conferences. A publishable manuscript will be submitted to relevant local and international journals. 11-Jul-2022 vii Study Protocol Version 1.3 15 th June 2022 Possible constraints Some study participants may refuse to be enrolled or withdraw for fear of delays to receive their treatment. The study conduct shall ensure that participants receive their treatment unhindered prior to commencement the in-depth interviews. There may be fears of interviews taking too long, effecting the participants time of getting home or conducting other planned activities hence leading to refusal of enrollment. The investigator shall make sure to use time management techniques to ensure that the interviews and discussions are completed by or before the allotted time as described in the informed consent.