title: Uptake of Isoniazid Preventive Therapy among Under-Five Children: TB Contact Investigation as an Entry Point.
abstract: A child's risk of developing tuberculosis (TB) can be reduced by nearly 60% with administration of 6 months course of isoniazid preventive therapy (IPT). However, uptake of IPT by national TB programs is low, and IPT delivery is a challenge in many resource-limited high TB-burden settings. Routinely collected program data was analyzed to determine the coverage and outcome of implementation of IPT for eligible under-five year old children in 28 health facilities in two regions of Ethiopia. A total of 504 index smear-positive pulmonary TB (SS+) cases were reported between October 2013 and June 2014 in the 28 health facilities. There were 282 under-five children registered as household contacts of these SS+ TB index cases, accounting for 17.9% of all household contacts. Of these, 237 (84%) were screened for TB symptoms, and presumptive TB was identified in 16 (6.8%) children. TB was confirmed in 5 children, producing an overall yield of 2.11% (95% confidence interval, 0.76-4.08%). Of 221 children eligible for IPT, 64.3% (142) received IPT, 80.3% (114) of whom successfully completed six months of therapy. No child developed active TB while on IPT. Contact screening is a good entry point for delivery of IPT to at risk children and should be routine practice as recommended by the WHO despite the implementation challenges.
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Yared
authors.identifier: 0000-0002-6631-7495
authors.initials: Y
authors.lastname: Tadesse
authors.affiliation: Amhara Regional Health Bureau, Bahir Dar, Ethiopia.
authors.forename: Nigussie
authors.initials: N
authors.lastname: Gebre
authors.affiliation: Oromia Regional Health Bureau, Addis Ababa, Ethiopia.
authors.forename: Shallo
authors.initials: S
authors.lastname: Daba
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Zewdu
authors.initials: Z
authors.lastname: Gashu
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Dereje
authors.initials: D
authors.lastname: Habte
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Nebiyu
authors.initials: N
authors.lastname: Hiruy
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Solomon
authors.initials: S
authors.lastname: Negash
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Kassahun
authors.initials: K
authors.lastname: Melkieneh
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Degu
authors.initials: D
authors.lastname: Jerene
authors.affiliation: United States Agency for International Development (USAID), Addis Ababa, Ethiopia.
authors.forename: Yared
authors.initials: Y
authors.lastname: K Haile
authors.affiliation: United States Agency for International Development (USAID), Addis Ababa, Ethiopia.
authors.forename: Yewulsew
authors.initials: Y
authors.lastname: Kassie
authors.affiliation: Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL TB) Project, Addis Ababa, Ethiopia.
authors.forename: Muluken
authors.initials: M
authors.lastname: Melese
authors.affiliation: Management Sciences for Health, Health Programs Group, Arlington, Virginia, United States of America.
authors.forename: Pedro
authors.initials: P
authors.lastname: G Suarez
mesh_terms: D000465:Algorithms; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003140:Communicable Disease Control; D016358:Contact Tracing; D003625:Data Collection; D005002:Ethiopia; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000627:therapeutic use*; D012306:Risk; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid