title: Operational challenges in managing Isoniazid Preventive Therapy in child contacts: a high-burden setting perspective.
abstract: BACKGROUND
  The study was conducted at a high TB-HIV burden primary health community clinic in Cape Town, South Africa. We describe the management of children under five years of age in household contact with a smear and/or culture-positive adult TB case.
  
  
  METHODS
  This study was a record review of routinely-collected programme data.
  
  
  RESULTS
  A total of 1094 adult TB case folders were reviewed. From all identified contacts, 149 children should have received IPT based on local guidelines; in only 2/149 IPT was initiated. Management of child contacts of sputum smear and/or culture-positive compared to sputum-negative TB patients were similar.
  
  
  CONCLUSIONS
  IPT delivery to children remains an operational challenge, especially in high TB-HIV burden communities. A tool to improve IPT management and targeting sputum smear and/or culture-positive TB child contacts may overcome some of these challenges and should be developed and piloted in such settings.
authors: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa. susanvanwyk@sun.ac.za
authors: Susan S
authors: SS
authors: van Wyk
authors: Anthony J
authors: AJ
authors: Reid
authors: Anna M
authors: AM
authors: Mandalakas
authors: Donald A
authors: DA
authors: Enarson
authors: Nulda
authors: N
authors: Beyers
authors: Julie
authors: J
authors: Morrison
authors: Anneke C
authors: AC
authors: Hesseling
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003151:Community Health Centers; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008485:Medical Audit; D015397:Program Evaluation; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid