Operational challenges in managing Isoniazid Preventive Therapy in child contacts: a high-burden setting perspective

BMC Public Health. 2011 Jul 8:11:544. doi: 10.1186/1471-2458-11-544.

Abstract

Background: The study was conducted at a high TB-HIV burden primary health community clinic in Cape Town, South Africa. We describe the management of children under five years of age in household contact with a smear and/or culture-positive adult TB case.

Methods: This study was a record review of routinely-collected programme data.

Results: A total of 1094 adult TB case folders were reviewed. From all identified contacts, 149 children should have received IPT based on local guidelines; in only 2/149 IPT was initiated. Management of child contacts of sputum smear and/or culture-positive compared to sputum-negative TB patients were similar.

Conclusions: IPT delivery to children remains an operational challenge, especially in high TB-HIV burden communities. A tool to improve IPT management and targeting sputum smear and/or culture-positive TB child contacts may overcome some of these challenges and should be developed and piloted in such settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use*
  • Child, Preschool
  • Community Health Centers
  • Female
  • Humans
  • Isoniazid / therapeutic use*
  • Male
  • Medical Audit
  • Program Evaluation
  • South Africa / epidemiology
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Tuberculosis / prevention & control

Substances

  • Antitubercular Agents
  • Isoniazid