title: Isoniazid Preventive Therapy among Children Living with Tuberculosis Patients: Is It Working? A Mixed-Method Study from Bhopal, India.
abstract: We assessed uptake of isoniazid preventive therapy (IPT) among child contacts of smear-positive tuberculosis (TB) patients and its implementation challenges from healthcare providers' and parents' perspectives in Bhopal, India.
  
  
  
  A mixed-method study design: quantitative phase (review of programme records and house-to-house survey of smear-positive TB patients) followed by qualitative phase (interviews of healthcare providers and parents).
  
  
  
  Of 59 child contacts (<6 years) of 129 index patients, 51 were contacted. Among them, 19 of 51 (37%) were screened for TB and one had TB. Only 11 of 50 (22%) children were started and 10 of 50 (20%) completed IPT. Content analysis of interviews revealed lack of awareness, risk perception among parents, cumbersome screening process, isoniazid stock-outs, inadequate knowledge among healthcare providers and poor programmatic monitoring as main barriers to IPT implementation.
  
  
  
  National TB programme should counsel parents, train healthcare providers, simplify screening procedures, ensure regular drug supply and introduce an indicator to strengthen monitoring and uptake of IPT.
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India.
authors.forename: Akash Ranjan
authors.initials: AR
authors.lastname: Singh
authors.affiliation: State TB Unit, Bhopal, India.
authors.forename: Atul
authors.initials: A
authors.lastname: Kharate
authors.affiliation: Department of Health and Family Welfare, Government of Karnataka, Udupi, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Bhat
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India.
authors.forename: Arun M
authors.initials: AM
authors.lastname: Kokane
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India.
authors.forename: Surya
authors.initials: S
authors.lastname: Bali
authors.affiliation: Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Swaroop
authors.initials: S
authors.lastname: Sahu
authors.affiliation: State TB Unit, Bhopal, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Verma
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Nagar
authors.affiliation: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.|International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Ajay Mv
authors.initials: AM
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000600:supply & distribution; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods*; D016358:Contact Tracing / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D007223:Infant; D007407:Interviews as Topic; D007538:Isoniazid / Q000494:pharmacology* / Q000600:supply & distribution; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010349:Patient Compliance / Q000208:ethnology* / Q000523:psychology; D056990:Post-Exposure Prophylaxis; D015397:Program Evaluation; D036301:Qualitative Research; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid
keywords: IPT; TB prevention; chemoprophylaxis; contact tracing