title: Implementing a tuberculosis child contact register to quantify children at risk for tuberculosis and HIV in Eldoret, Kenya.
abstract: METHODS
  Tuberculosis (TB) clinic in Eldoret, Kenya.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  A CCR was implemented in routine care with health care workers querying index cases regarding child contacts. Data were retrospectively analyzed.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Memorial Hospital of Rhode Island Brown Family Medicine Residency Program, Pawtucket, Rhode Island, USA.
authors.forename: D
authors.initials: D
authors.lastname: Szkwarko
authors.affiliation: Moi University School of Medicine, Eldoret, Kenya.
authors.forename: F
authors.initials: F
authors.lastname: Ogaro
authors.affiliation: United States Agency for International Development- Academic Model Providing Access to Healthcare (USAID/AMPATH) Partnership, Eldoret, Kenya.
authors.forename: P
authors.initials: P
authors.lastname: Owiti
authors.affiliation: United States Agency for International Development- Academic Model Providing Access to Healthcare (USAID/AMPATH) Partnership, Eldoret, Kenya ; Warren Alpert School of Medicine of Brown University, Providence, Rhode Island, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Carter
keywords: isoniazid preventive therapy; pediatric tuberculosis; tuberculosis household contacts