H R Shivaramakrishna1, A Frederick2, A Shazia1, L Murali3, S Satyanarayana4, S A Nair1, A M Kumar4, P K Moonan5. 1. <label>*</label>World Health Organization Country Office in India, New Delhi. 2. <label><sup>†</sup></label>Revised National TB Control Programme (RNTCP) District Tuberculosis Unit, Krishnagiri and Dharmapuri Districts, Tamilnadu. 3. <label><sup>‡</sup></label>RNTCP State Tuberculosis Unit, Tamilnadu. 4. <label><sup>§</sup></label>International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India. 5. <label><sup>¶</sup></label>Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract
SETTING: Two districts of Tamil Nadu, India OBJECTIVES: To determine the proportion of household contacts aged <6 years of patients with tuberculosis (TB) with positive sputum microscopy results who initiated and completed isoniazid preventive treatment (IPT), and to determine reasons for non-initiation and non-completion of IPT. DESIGN: Household visits were conducted on a random sample of adult patients registered during January-June 2012 to identify household contacts aged <6 years. RESULTS: Among 271 children living with 691 index patients, 218 (80%) were evaluated and 9 (4%) were diagnosed with TB. Of 209 remaining contacts, 70 (33%) started IPT and 16 (22.9%) completed a full course of IPT. Of 139 contacts who did not start IPT, five developed TB disease. Reasons for non-initiation of IPT included no home visit by the field staff (19%) and no education about IPT (61%). Reasons for non-completion included isoniazid not provided (52%) and long duration of treatment (28%). CONCLUSION: This study shows that Revised National TB Programme guidance was not being followed and IPT implementation was poor. Poor IPT uptake represents a missed opportunity to prevent future TB cases. Provision of IPT may be improved through training, improved logistics and enhanced supervision and monitoring.
SETTING: Two districts of Tamil Nadu, India OBJECTIVES: To determine the proportion of household contacts aged <6 years of patients with tuberculosis (TB) with positive sputum microscopy results who initiated and completed isoniazid preventive treatment (IPT), and to determine reasons for non-initiation and non-completion of IPT. DESIGN: Household visits were conducted on a random sample of adult patients registered during January-June 2012 to identify household contacts aged <6 years. RESULTS: Among 271 children living with 691 index patients, 218 (80%) were evaluated and 9 (4%) were diagnosed with TB. Of 209 remaining contacts, 70 (33%) started IPT and 16 (22.9%) completed a full course of IPT. Of 139 contacts who did not start IPT, five developed TB disease. Reasons for non-initiation of IPT included no home visit by the field staff (19%) and no education about IPT (61%). Reasons for non-completion included isoniazid not provided (52%) and long duration of treatment (28%). CONCLUSION: This study shows that Revised National TB Programme guidance was not being followed and IPT implementation was poor. Poor IPT uptake represents a missed opportunity to prevent future TB cases. Provision of IPT may be improved through training, improved logistics and enhanced supervision and monitoring.
Authors: Dick Menzies; Marie-Josée Dion; Barry Rabinovitch; Sharyn Mannix; Paul Brassard; Kevin Schwartzman Journal: Am J Respir Crit Care Med Date: 2004-06-01 Impact factor: 21.405
Authors: Kathleen R Page; Frangiscos Sifakis; Ruben Montes de Oca; Wendy A Cronin; Meg C Doherty; Lynn Federline; Sarah Bur; Thomas Walsh; Walter Karney; James Milman; Nancy Baruch; Akintoye Adelakun; Susan E Dorman Journal: Arch Intern Med Date: 2006-09-25
Authors: Merrin E Rutherford; Rovina Ruslami; Winni Maharani; Indria Yulita; Sarah Lovell; Reinout Van Crevel; Bachti Alisjahbana; Philip C Hill Journal: BMC Res Notes Date: 2012-01-06
Authors: S Satyanarayana; R Subbaraman; P Shete; G Gore; J Das; A Cattamanchi; K Mayer; D Menzies; A D Harries; P Hopewell; M Pai Journal: Int J Tuberc Lung Dis Date: 2015-07 Impact factor: 2.373
Authors: L Coprada; S Yoshimatsu; A Querri; E Lopez; P Agujo; M R Paulino; A Medina; A M C Garfin; A Ohkado Journal: Public Health Action Date: 2016-12-21
Authors: Dick D Chamla; Chukwuemeka Asadu; Abiola Davies; Arjan de Wagt; Oluwafunke Ilesanmi; Daniel Adeyinka; Ebun Adejuyigbe Journal: J Int AIDS Soc Date: 2015-12-02 Impact factor: 5.396
Authors: Daria Szkwarko; Yael Hirsch-Moverman; Lienki Du Plessis; Karen Du Preez; Catherine Carr; Anna M Mandalakas Journal: PLoS One Date: 2017-08-01 Impact factor: 3.240