Open AccessUptake of Isoniazid Preventive Therapy among Under-Five Children: TB Contact Investigation as an Entry Point
Author(s) -
Yared Tadesse,
Nigussie Gebre,
Shallo Daba,
Zewdu Gashu,
Dereje Habte,
Nebiyu Hiruy,
Solomon Negash,
Kassahun Melkieneh,
Degu Jerene,
Yared Kebede Haile,
Yewulsew Kassie,
Muluken Melese,
Pedro Suarez
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0155525
Subject(s) - medicine , isoniazid , tuberculosis , contact tracing , pediatrics , confidence interval , environmental health , disease , pathology , covid-19 , infectious disease (medical specialty)
A child’s risk of developing tuberculosis (TB) can be reduced by nearly 60% with administration of 6 months course of isoniazid preventive therapy (IPT). However, uptake of IPT by national TB programs is low, and IPT delivery is a challenge in many resource-limited high TB-burden settings. Routinely collected program data was analyzed to determine the coverage and outcome of implementation of IPT for eligible under-five year old children in 28 health facilities in two regions of Ethiopia. A total of 504 index smear-positive pulmonary TB (SS+) cases were reported between October 2013 and June 2014 in the 28 health facilities. There were 282 under-five children registered as household contacts of these SS+ TB index cases, accounting for 17.9% of all household contacts. Of these, 237 (84%) were screened for TB symptoms, and presumptive TB was identified in 16 (6.8%) children. TB was confirmed in 5 children, producing an overall yield of 2.11% (95% confidence interval, 0.76–4.08%). Of 221 children eligible for IPT, 64.3% (142) received IPT, 80.3% (114) of whom successfully completed six months of therapy. No child developed active TB while on IPT. Contact screening is a good entry point for delivery of IPT to at risk children and should be routine practice as recommended by the WHO despite the implementation challenges.