title: Isoniazid preventive treatment in children in two districts of South India: does practice follow policy?
abstract: METHODS
  Two districts of Tamil Nadu, India
  
  
  OBJECTIVE
  To determine the proportion of household contacts aged <6 years of patients with tuberculosis (TB) with positive sputum microscopy results who initiated and completed isoniazid preventive treatment (IPT), and to determine reasons for non-initiation and non-completion of IPT.
  
  
  METHODS
  Household visits were conducted on a random sample of adult patients registered during January-June 2012 to identify household contacts aged <6 years.
  
  
  RESULTS
  Among 271 children living with 691 index patients, 218 (80%) were evaluated and 9 (4%) were diagnosed with TB. Of 209 remaining contacts, 70 (33%) started IPT and 16 (22.9%) completed a full course of IPT. Of 139 contacts who did not start IPT, five developed TB disease. Reasons for non-initiation of IPT included no home visit by the field staff (19%) and no education about IPT (61%). Reasons for non-completion included isoniazid not provided (52%) and long duration of treatment (28%).
  
  
  CONCLUSIONS
  This study shows that Revised National TB Programme guidance was not being followed and IPT implementation was poor. Poor IPT uptake represents a missed opportunity to prevent future TB cases. Provision of IPT may be improved through training, improved logistics and enhanced supervision and monitoring.
authors.affiliation: <label>*</label>World Health Organization Country Office in India, New Delhi.
authors.forename: H R
authors.initials: HR
authors.lastname: Shivaramakrishna
authors.affiliation: <label><sup>†</sup></label>Revised National TB Control Programme (RNTCP) District Tuberculosis Unit, Krishnagiri and Dharmapuri Districts, Tamilnadu.
authors.forename: A
authors.initials: A
authors.lastname: Frederick
authors.affiliation: <label>*</label>World Health Organization Country Office in India, New Delhi.
authors.forename: A
authors.initials: A
authors.lastname: Shazia
authors.affiliation: <label><sup>‡</sup></label>RNTCP State Tuberculosis Unit, Tamilnadu.
authors.forename: L
authors.initials: L
authors.lastname: Murali
authors.affiliation: <label><sup>§</sup></label>International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
authors.affiliation: <label>*</label>World Health Organization Country Office in India, New Delhi.
authors.forename: S A
authors.initials: SA
authors.lastname: Nair
authors.affiliation: <label><sup>§</sup></label>International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
authors.forename: A M
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: <label><sup>¶</sup></label>Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Moonan
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005260:Female; D006291:Health Policy; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D009313:National Health Programs; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid