R Triasih1, R S Padmawati2, T Duke3, C Robertson4, S M Sawyer5, S M Graham6. 1. Department of Paediatrics, Faculty of Medicine, Dr Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia; Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia. 2. Department of Public Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia. 3. Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia. 4. Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia. 5. Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia. 6. Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia; International Union Against Tuberculosis and Lung Disease, Paris, France.
Abstract
BACKGROUND: Tuberculosis (TB) can be prevented using isoniazid preventive therapy (IPT) among child contacts. However, the benefits of IPT depend on adherence to at least 6 months of daily treatment. A greater understanding of the barriers to and facilitators of adherence to IPT in resource-poor settings is required to optimise the benefits. METHODS: We prospectively evaluated adherence to IPT and its associated factors among child contacts (age 0-5 years) eligible for IPT. We undertook in-depth interviews with care givers and a focus group discussion with health care workers, which were thematically analysed to explore barriers to and facilitators of adherence from the perspective of both care givers and health workers. RESULTS: Of 99 eligible children, 49 (49.5%) did not complete 6 months of IPT. Children whose care giver collected their IPT medications from primary health centres were more likely to have incomplete adherence than those who collected them from hospitals (aOR 2.9, 95%CI 1.1-7.8). Thematic analyses revealed major barriers to and facilitators of adherence: regimen-related, care giver-related and health care-related factors, social support and access. Many of these factors are readily modifiable. CONCLUSION: Providing information about IPT and improving accessibility for care givers to receive IPT at the primary health care facility should be priorities to facilitate implementation.
BACKGROUND:Tuberculosis (TB) can be prevented using isoniazid preventive therapy (IPT) among child contacts. However, the benefits of IPT depend on adherence to at least 6 months of daily treatment. A greater understanding of the barriers to and facilitators of adherence to IPT in resource-poor settings is required to optimise the benefits. METHODS: We prospectively evaluated adherence to IPT and its associated factors among child contacts (age 0-5 years) eligible for IPT. We undertook in-depth interviews with care givers and a focus group discussion with health care workers, which were thematically analysed to explore barriers to and facilitators of adherence from the perspective of both care givers and health workers. RESULTS: Of 99 eligible children, 49 (49.5%) did not complete 6 months of IPT. Children whose care giver collected their IPT medications from primary health centres were more likely to have incomplete adherence than those who collected them from hospitals (aOR 2.9, 95%CI 1.1-7.8). Thematic analyses revealed major barriers to and facilitators of adherence: regimen-related, care giver-related and health care-related factors, social support and access. Many of these factors are readily modifiable. CONCLUSION: Providing information about IPT and improving accessibility for care givers to receive IPT at the primary health care facility should be priorities to facilitate implementation.
Authors: Yael Hirsch-Moverman; Joanne E Mantell; Limakatso Lebelo; Andrea A Howard; Anneke C Hesseling; Sharon Nachman; Koen Frederix; Llang Bridget Maama; Wafaa M El-Sadr Journal: BMC Health Serv Res Date: 2020-05-25 Impact factor: 2.655
Authors: Francine Mwayuma Birungi; Stephen Michael Graham; Jeannine Uwimana; Angèle Musabimana; Brian van Wyk Journal: PLoS One Date: 2019-02-11 Impact factor: 3.240
Authors: Anca Vasiliu; Sabrina Eymard-Duvernay; Boris Tchounga; Daniel Atwine; Elisabete de Carvalho; Sayouba Ouedraogo; Michael Kakinda; Patrice Tchendjou; Stavia Turyahabwe; Albert Kuate Kuate; Georges Tiendrebeogo; Peter J Dodd; Stephen M Graham; Jennifer Cohn; Martina Casenghi; Maryline Bonnet Journal: Trials Date: 2021-03-02 Impact factor: 2.279
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