Nishi Suryavanshi1, Matthew Murrill2, Amita Gupta1,2, Michael Hughes3, Anneke Hesseling4, Soyeon Kim3, Linda Naini5, Lynne Jones6, Betsy Smith7, Nikhil Gupte1,2, Rodney Dawson8, Vidya Mave1,2, Sushant Meshram1, Alberto Mendoza-Ticona9, Jorge Sanchez10, Nagalingeswaran Kumarasamy11, Kyla Comins12, Francesca Conradie13, Justin Shenje14, Sandy Nerette Fontain15, Anthony Garcia-Prats4, Aida Asmelash16, Supalert Nedsuwan17, Lerato Mohapi18, Umesh Lalloo19, Ana Cristina Garcia Ferreira20, Elisha Okeyo21, Susan Swindells22, Gavin Churchyard23,24,25, N Sarita Shah26. 1. Byramjee Jeejeebhoy Government Medical College Clinical Trials Unit, Pune, India. 2. Johns Hopkins Medical Institutions, Baltimore, Maryland. 3. Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 4. Desmond Tutu TB Centre, Stellenbosch University, Tygerberg, South Africa. 5. Social and Scientific Systems, Inc, Silver Springs, Maryland. 6. Frontier Science and Technology Research Foundation, Amherst, New York. 7. National Institutes of Health, Bethesda, Maryland. 8. University of Cape Town Lung Institute, Mowbray, South Africa. 9. Barranco Clinical Research Site. 10. Asociación Civil Impacta Salud y Educación, San Miguel Clinical Research Site, Lima, Peru. 11. Chennai Antiviral Research and Treatment Clinical Research Site, India. 12. TASK Applied Science Clinical Research Site, Bellville. 13. University of the Witwatersrand Helen Joseph Hospital, Johannesburg. 14. South African Tuberculosis Vaccine Initiative, Cape Town, South Africa. 15. GHESKIO Centers-Institute of Infectious Diseases and Reproductive Health, Port-au-Prince, Haiti. 16. Gaborone Clinical Research Site, Botswana. 17. Program for HIV Prevention and Treatment-Chiangrai Prachanukroh Hospital, Thailand. 18. Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg. 19. Durban International Clinical Research Site, South Africa. 20. Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 21. Kenya Medical Research Institute, Kisumu. 22. University of Nebraska Medical Center, Omaha. 23. Aurum Institute. 24. School of Public Health, University of the Witwatersrand, Johannesburg. 25. Advancing Care and Treatment for TB/HIV, South African Medical Research Council, Parktown, South Africa. 26. Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
BACKGROUND: Household contacts (HHCs) of individuals with multidrug-resistant tuberculosis (MDR-TB) are at high risk of infection and subsequent disease. There is limited evidence on the willingness of MDR-TB HHCs to take MDR-TB preventive therapy (MDR TPT) to decrease their risk of TB disease. METHODS: In this cross-sectional study of HHCs of MDR-TB and rifampicin-resistant tuberculosis (RR-TB) index cases from 16 clinical research sites in 8 countries, enrollees were interviewed to assess willingness to take a hypothetical, newly developed MDR TPT if offered. To identify factors associated with willingness to take MDR TPT, a marginal logistic model was fitted using generalized estimating equations to account for household-level clustering. RESULTS: From 278 MDR-TB/RR-TB index case households, 743 HHCs were enrolled; the median age of HHCs was 33 (interquartile range, 22-49) years, and 62% were women. HHC willingness to take hypothetical MDR TPT was high (79%) and remained high even with the potential for mild side effects (70%). Increased willingness was significantly associated with current employment or schooling (adjusted odds ratio [aOR], 1.83 [95% confidence interval {CI}, 1.07-3.13]), appropriate TB-related knowledge (aOR, 2.22 [95% CI, 1.23-3.99]), confidence in taking MDR TPT (aOR, 7.16 [95% CI, 3.33-15.42]), and being comfortable telling others about taking MDR TPT (aOR, 2.29 [95% CI, 1.29-4.06]). CONCLUSIONS: The high percentage of HHCs of MDR-TB/RR-TB index cases willing to take hypothetical MDR TPT provides important evidence for the potential uptake of effective MDR TPT when implemented. Identified HHC-level variables associated with willingness may inform education and counseling efforts to increase HHC confidence in and uptake of MDR TPT.
BACKGROUND: Household contacts (HHCs) of individuals with multidrug-resistant tuberculosis (MDR-TB) are at high risk of infection and subsequent disease. There is limited evidence on the willingness of MDR-TB HHCs to take MDR-TB preventive therapy (MDR TPT) to decrease their risk of TB disease. METHODS: In this cross-sectional study of HHCs of MDR-TB and rifampicin-resistant tuberculosis (RR-TB) index cases from 16 clinical research sites in 8 countries, enrollees were interviewed to assess willingness to take a hypothetical, newly developed MDR TPT if offered. To identify factors associated with willingness to take MDR TPT, a marginal logistic model was fitted using generalized estimating equations to account for household-level clustering. RESULTS: From 278 MDR-TB/RR-TB index case households, 743 HHCs were enrolled; the median age of HHCs was 33 (interquartile range, 22-49) years, and 62% were women. HHC willingness to take hypothetical MDR TPT was high (79%) and remained high even with the potential for mild side effects (70%). Increased willingness was significantly associated with current employment or schooling (adjusted odds ratio [aOR], 1.83 [95% confidence interval {CI}, 1.07-3.13]), appropriate TB-related knowledge (aOR, 2.22 [95% CI, 1.23-3.99]), confidence in taking MDR TPT (aOR, 7.16 [95% CI, 3.33-15.42]), and being comfortable telling others about taking MDR TPT (aOR, 2.29 [95% CI, 1.29-4.06]). CONCLUSIONS: The high percentage of HHCs of MDR-TB/RR-TB index cases willing to take hypothetical MDR TPT provides important evidence for the potential uptake of effective MDR TPT when implemented. Identified HHC-level variables associated with willingness may inform education and counseling efforts to increase HHC confidence in and uptake of MDR TPT.
Authors: Maile Y Karris; Susan E Beekmann; Sanjay R Mehta; Christy M Anderson; Philip M Polgreen Journal: Clin Infect Dis Date: 2013-12-06 Impact factor: 9.079
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Authors: A Bedini; E Garlassi; C Stentarelli; S Petrella; M Meacci; B Meccugni; M Meschiari; E Franceschini; S Cerri; A Brasacchio; F Rumpianesi; L Richeldi; C Mussini Journal: New Microbes New Infect Date: 2016-04-07
Authors: V Rouzier; M Murrill; S Kim; L Naini; J Shenje; E Mitchell; M Raesi; M Lourens; A Mendoza; F Conradie; N Suryavanshi; M Hughes; S Shah; G Churchyard; S Swindells; A Hesseling; A Gupta Journal: Int J Tuberc Lung Dis Date: 2022-10-01 Impact factor: 3.427