title: Does an isoniazid prophylaxis register improve tuberculosis contact management in South African children?
abstract: METHODS
  We compared the change in child household contact management of pulmonary tuberculosis (TB) cases before and after the implementation of an isoniazid preventive therapy (IPT) register in an urban clinic setting in Cape Town, South Africa.
  
  
  OBJECTIVE
  We determined if the presence of an IPT register was associated with an increase in the number of child contacts identified per infectious case and the proportion of identified children who were started on IPT.
  
  
  METHODS
  We reviewed routine programme data on IPT delivery to children during two time periods (May 2008-October 2008 and May 2011-October 2011), before and after the implementation of an IPT register used by routine clinic personnel.
  
  
  RESULTS
  Adult TB case demographic and clinical characteristics from the two observation periods were similar. During the post-register period, more child contacts per adult case were identified (0.7 (54 children) vs. 0.3 (24 children)), more of the identified children were started on IPT (54 vs. 4) and 37% of those who started, completed six months of treatment compared to the pre-register period where no adherence information was recorded.
  
  
  CONCLUSIONS
  After pilot implementation of an IPT register, documented identification of child contacts, IPT initiation and IPT adherence documentation in TB exposed children was improved. Our findings support further exploration of the potential impact of using standardised IPT recording and reporting in routine clinics in high-burden TB settings to improve TB prevention efforts targeted at young children. Future efforts to improve IPT delivery should be systematic and comprehensive in order to support a change in current operational IPT delivery practices in TB programs.
authors: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
authors: Nelda
authors: N
authors: van Soelen
authors: Karen
authors: K
authors: du Preez
authors: Susan S
authors: SS
authors: van Wyk
authors: Anna M
authors: AM
authors: Mandalakas
authors: Don A
authors: DA
authors: Enarson
authors: Anthony J
authors: AJ
authors: Reid
authors: Anneke C
authors: AC
authors: Hesseling
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology*; D008297:Male; D012042:Registries; D013019:South Africa / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*
chemical_list: D007538:Isoniazid