Evaluation of adherence to tuberculosis screening in children

Abstract

Introduction: In countries with a high incidence of tuberculosis (TB), screening have been shown to be effective in further reducing TB incidence. TB screening in children at high risk of TB infection can reduce rates of latent TB infection (LTBI) and TB infection (TBI). Objective: Evaluate adherence to TB screening program in children. Methods: We retrospectively studied data of children referred to our TB screening consultation, in pediatric pulmonology department, from januray 2014 to august 2015. Children in household contact with a TB index case, were screened for TBI or LTBI. Each child had a medical evaluation, tuberculin skin test (TST), chest X-ray and were followed up at one month, 3 months and 6 months. We measured rate of adherence and estimated factors associated to good adherence. Results: Children were aged from 2 months to 16 years. Of 87 children screened, 29.8% had LTBI and 6.9% had TBI. Sixty one children (70.1%) underwent prophylactic therapy. At one month, 70.1% children attended meeting with doctor, 37.9% at 3 months, and 5.7% at 6 months. Near relationship (59.3% vs 40.7%, p=0.04) and close contact with TB index case (55.9% vs 44.1%, p=0.03), seem to be factors associated with good adherence. Age less than 5 (46.7% vs 53.3%, p=0.107) and symptoms such as cough, fever and weight loss were not significant factors. Children with chest X-ray anomalies (61.9% vs 38.1%, p=0.284) and positive TST (54.8% vs 45.2%, p=0.584) had not significant better adherence. Only 56.3% children were compliant to therapy. Conclusion: TB investigation for children in household contact with an index case is important to detect LTBI cases and treat them early. But we should insist on adherence and compliance to therapy.