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Objectives <p>To assesses the coverage, adherence, reasons for non-initiation and non-completion of tuberculosis preventive treatment (TPT) among household child contacts (HHCC) of pulmonary tuberculosis (TB).</p> Methods <p>This cross-sectional study was conducted across eight sites in India. Estimated sample size was 200 per site. Information was collected through record review and house-to-house visits of HHCCs of notified pulmonary TB cases during January to March 2022. Coverage and adherence was assessed by proportion of eligible HHCC initiated and completed TPT, respectively.</p> Results <p>Of 2554 HHCCs eligible for TPT, initiation and completion rate was 34% and 22%, respectively. Across the sites the median time to conduct home visit was 14 d (IQR 9, 22) and TPT initiation was 7 d (IQR 1, 21). Reasons for the non-initiation were no information provided by paramedical workers (82%), information provided by paramedical workers but TPT was not given (19%), parents felt it’s not important (9%), and fear of side-effects (3%). Reasons for non-completion were: TPT received for less than six months (from healthcare providers) (54%), advised for the lesser duration TPT by the doctors (4%), parents felt completion was not important (32%), parents’ fear of side-effects or myth (5%), and HHCC complained of side-effect (0.7%).</p> Conclusions <p>Inadequate emphasis on home visits leads to TPT initiation in only one-third and completion in less than one-fourth of eligible HHCCs. This poor coverage was primarily due to the health system related issues. Rarely reported TPT side-effects highlighted its safety.</p>

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A Situational Analysis and an Untapped Opportunity for Tackling Challenges Associated with Coverage of Tuberculosis Preventive Treatment: A Multi-Centric Study in India

  • 期刊论文

  • 发表日期：

    2025年2月3日

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  • Amber Kumar,
  • Akash Ranjan Singh,
  • Praveen Anand,
  • Dhruvendra Pandey,
  • Sarika Gupta,
  • Lalitha K,
  • Inder Puri,
  • BrajRaj S. Gosh,
  • Manjeet Singh Chalga,
  • Manjula Singh,
  • Bhavna Dhingra,
  • Shikha Malik,
  • Mahesh Maheshwari,
  • Alkesh Khurrana,
  • Manoj Verma,
  • Priyanka,
  • Deepa Tiwari,
  • Neeraj Rai,
  • Nikhitha Pradeep,
  • Vikrant Kabirpanthi,
  • Somi Soni,
  • Pragati Chavan,
  • Sanjeev Bakshi,
  • Dilkhush Harijan,
  • Hitesh Tiwari,
  • Gajraj Singh,
  • Smriti Pandey,
  • Nirmal kumar Mandana,
  • Shakti Singh Solanki,
  • Ajay Verma,
  • Ranveer Yadav,
  • Aniket Yadav,
  • Suman Gadicherla,
  • Aishwarya R. G,
  • Divya Goswami,
  • Rati Ram Meena,
  • C. S. Modi,
  • Gunjan Soni,
  • M. G. Choudhary,
  • Rekha Acharya

摘要

Objectives

To assesses the coverage, adherence, reasons for non-initiation and non-completion of tuberculosis preventive treatment (TPT) among household child contacts (HHCC) of pulmonary tuberculosis (TB).

Methods

This cross-sectional study was conducted across eight sites in India. Estimated sample size was 200 per site. Information was collected through record review and house-to-house visits of HHCCs of notified pulmonary TB cases during January to March 2022. Coverage and adherence was assessed by proportion of eligible HHCC initiated and completed TPT, respectively.

Results

Of 2554 HHCCs eligible for TPT, initiation and completion rate was 34% and 22%, respectively. Across the sites the median time to conduct home visit was 14 d (IQR 9, 22) and TPT initiation was 7 d (IQR 1, 21). Reasons for the non-initiation were no information provided by paramedical workers (82%), information provided by paramedical workers but TPT was not given (19%), parents felt it’s not important (9%), and fear of side-effects (3%). Reasons for non-completion were: TPT received for less than six months (from healthcare providers) (54%), advised for the lesser duration TPT by the doctors (4%), parents felt completion was not important (32%), parents’ fear of side-effects or myth (5%), and HHCC complained of side-effect (0.7%).

Conclusions

Inadequate emphasis on home visits leads to TPT initiation in only one-third and completion in less than one-fourth of eligible HHCCs. This poor coverage was primarily due to the health system related issues. Rarely reported TPT side-effects highlighted its safety.