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

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 rou...

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Published in:BMC public health Vol. 11; no. 1; p. 544
Main Authors: van Wyk, Susan S, Reid, Anthony J, Mandalakas, Anna M, Enarson, Donald A, Beyers, Nulda, Morrison, Julie, Hesseling, Anneke C
Format: Journal Article
Language:English
Published: London BioMed Central 08.07.2011
BioMed Central Ltd
BMC
Subjects:
Adult
Antitubercular Agents - therapeutic use
Biostatistics
Care and treatment
Child, Preschool
Children
Community Health Centers
Environmental Health
Epidemiology
Female
Health aspects
Humans
Infectious Disease epidemiology
Isoniazid
Isoniazid - therapeutic use
Male
Medical Audit
Medicine
Medicine & Public Health
Prevention
Program Evaluation
Public Health
Research Article
South Africa - epidemiology
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - drug therapy
Tuberculosis - epidemiology
Tuberculosis - prevention & control
Vaccine
South Africa
Data Extraction Tool
Eligible Child
Sputum Smear
Child Contact
Isoniazid Preventive Therapy
ISSN:1471-2458, 1471-2458
Online Access:Get full text
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Summary: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.
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ISSN:1471-2458
1471-2458
DOI:10.1186/1471-2458-11-544