title: Improving screening and chemoprophylaxis among child contacts in India's RNTCP: a pilot study.
abstract: BACKGROUND
  While contact screening and chemoprophylaxis is recommended by India's Revised National Tuberculosis Control Programme for asymptomatic children aged <6 years who are household contacts of smear-positive pulmonary tuberculosis (PTB) patients, implementation is suboptimal.
  
  
  OBJECTIVE
  To evaluate the effectiveness of an isoniazid preventive therapy (IPT) register and card in improving the adherence of health care workers (HCWs) to programmatic guidelines.
  
  
  METHODS
  This prospective study was conducted in two Tuberculosis Units in South India. Child contacts of smear-positive  PTB patients initiated on treatment between November 2009 and January 2010 were screened, and IPT was initiated in asymptomatic children. HCWs were trained in the use of the IPT register and card. The process was evaluated using patient and HCW interviews.
  
  
  RESULTS
  Of 87 children identified  aged <6 years, 71 (82%) were traced by HCWs; 53 were screened for TB and initiated on IPT, and 39 completed treatment. HCWs expressed satisfaction with the use of the IPT card and register, saying that it helped them to remember to complete required tasks.
  
  
  CONCLUSIONS
  In a programme  setting, with HCW training and introduction of specific documentation (IPT card and register), implementation of contact tracing and chemoprophylaxis for child contacts improved from 19% to 61%.
authors: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors: B
authors: B
authors: Rekha
authors: K
authors: K
authors: Jagarajamma
authors: V
authors: V
authors: Chandrasekaran
authors: F
authors: F
authors: Wares
authors: R
authors: R
authors: Sivanandham
authors: S
authors: S
authors: Swaminathan
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D018890:Chemoprevention / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing / Q000379:methods / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010865:Pilot Projects; D011446:Prospective Studies; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid