Implementing a tuberculosis child contact register to quantify children at risk for tuberculosis and HIV in Eldoret, Kenya.

Abstract

Tuberculosis (TB) clinic in Eldoret, Kenya. To identify TB exposed children through the implementation of a child contact register (CCR). To assess the demographics of children exposed to TB and the potential for initiation of isoniazid preventive therapy (IPT) in this cohort. A CCR was implemented in routine care with health care workers querying index cases regarding child contacts. Data were retrospectively analyzed. In 12 months, the CCR revealed 580 children exposed to TB. Of these, 58% were exposed to smear-positive TB and 30% were aged <5 years. Of those exposed to smear-positive TB, 15% may have qualified for IPT initiation. Only 6 (1%) child contacts were screened for TB disease. More than 50% of the children with human immunodeficiency virus (HIV) positive mothers had not been HIV tested. Implementation of a CCR is a possible first step in child contact identification and management, which requires minimal resources and identifies children at risk for TB and HIV. Child contact screening and IPT initiation remain a challenge, and additional strategies are urgently needed.