Impact of health education on preventive therapy with integrated monitoring of Tuberculosis cases

Abstract

Abstract Background The hilly state of Sikkim has the highest proportion of Tuberculosis (TB) cases in India. Increasing compliance of preventive therapy among paediatric contacts will help to cut down transmission. Separate visits are being made under the current National TB control programme to monitor preventive therapy & treatment of index Tuberculosis cases in the same house. Integrated monitoring for preventive therapy of the contacts & treatment of index cases will ensure compliance of both but at no extra cost. Methods It was a prospective study with universal sampling of all the sputum positive TB patients in East Sikkim. Home visits were conducted initially, after 3 months with health education intervention and finally at the end of 6 months. Focus group discussion (FGD) was done amongst the TB home visitors regarding monitoring visits. Results Out of the total 124 paediatric contacts, 86 (69.4%) initiated Isoniazid Preventive Therapy (IPT). After 6 months of follow up, 114 (91.9%) children had completed IPT after the health education intervention. In 96.7% of the houses, it was possible to monitor both index cases and the paediatric contacts simultaneously with the same work force. Content analysis of FGD among TB home visitors revealed lack of programme clarity regarding integrated visits for monitoring of both contacts and index cases. Conclusions Health education intervention was found to be an effective tool for increasing compliance of IPT. This study had a huge & far-reaching impact in terms of providing the evidence that integrated monitoring for preventive therapy of the contacts along with health education & monitoring of treatment of index cases can be done simultaneously with no extra cost in the ongoing TB Control Programme. Key messages Health education intervention increased compliance of IPT. Integrated monitoring for preventive therapy along with health education & monitoring of index cases can be done with no extra cost.