Abstract
Background The World Health Organization recommends that all children below the age of five who have household contact with an infectious tuberculosis case should receive isoniazid preventive treatment for at least six months after the active tuberculosis disease has been ruled out. This research aims to determine the adherence of children, eligible for isoniazid preventive treatment, to the treatment who had contact with pulmonary tuberculosis patients. Methods A mixed study design was used to prospectively assess the adherence to IPT among children under the age of 5 in contact with pulmonary TB patients through the quantitative study design and barriers of adherence in view of health care professionals and the family of children through a descriptive qualitative study. The study was conducted from July 2019 to December 2019 in Addis Ababa. Data were collected by a structured datasheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants. Result The ratio of the total number of pulmonary tuberculosis index cases recruited into the study to the number of child contacts aged less than 5 years was 1 : 1.32. The total isoniazid preventive treatment uptake in this study was 75.2%; one-fifth (21.3%) of the children who started IPT did not complete the full course of six-month isoniazid preventive treatment. Except for HIV not to be tested (P < 0.001), there was no significant association of the listed risk factors in default to complete the full six months of preventive treatment. Conclusion Enrolment of eligible children for isoniazid preventive treatment in the urban city Addis Ababa was still below the target of the World Health Organization End tuberculosis strategy by 2030. The treatment adherence rate also needs a great deal of effort to achieve the strategy. Child default after the first visit indicates a lack of understanding about the benefit and safety of preventive therapy in young children among families of TB patients, and awareness-creating efforts by health extension workers will help to improve the outcomes.
Highlights
Tuberculosis is highly infectious; a person with active TB may be able to infect up to 15 people a year by being in close contact
Children exposed to index cases of TB, sputum smear-positive (PTB) ones, are at risk of infection and are at high risk of developing the disease when infected with tubercle bacilli, especially infants and young children (
Study Settings. e study was conducted in Addis Ababa, the capital of Ethiopia, inhabited by about 4 million people, the majority being of urban origin [13]. e city has more than 141 public health centers (PHCs) in its 10 subcity offering tuberculosis diagnosis and treatment for patients with tuberculosis [14]
Summary
Tuberculosis is highly infectious; a person with active TB may be able to infect up to 15 people a year by being in close contact. Tuberculosis, one of the top ten causes of death, is a significant contributor to the international and the national burden of disease [1]. According to figures from the World Health Organization (WHO) in 2018, 10% of the 9 million cases of tuberculosis (TB) occurred in children, resulting in 210,000 TB-related deaths, including 170,000 in HIV-negative children. International Journal of Microbiology e WHO recommends that all children under the age of five who have household contact with an infectious TB case should be given IPT for at least six months after the active TB disease has been ruled out [5] Children exposed to index cases of TB, sputum smear-positive (PTB) ones, are at risk of infection and are at high risk of developing the disease when infected with tubercle bacilli, especially infants and young children (
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