Isoniazid Preventive Therapy among Children Living with Tuberculosis Patients: Is It Working? A Mixed-Method Study from Bhopal, India

J Trop Pediatr. 2017 Aug 1;63(4):274-285. doi: 10.1093/tropej/fmw086.

Abstract

Objective: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: IPT; TB prevention; chemoprophylaxis; contact tracing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / pharmacology*
  • Antitubercular Agents / supply & distribution
  • Child, Preschool
  • Communicable Disease Control / methods*
  • Contact Tracing / methods*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel
  • Health Services Accessibility
  • Humans
  • India
  • Infant
  • Interviews as Topic
  • Isoniazid / pharmacology*
  • Isoniazid / supply & distribution
  • Male
  • Middle Aged
  • National Health Programs
  • Patient Compliance / ethnology*
  • Patient Compliance / psychology
  • Post-Exposure Prophylaxis
  • Program Evaluation
  • Qualitative Research
  • Sputum / microbiology
  • Tuberculosis / diagnosis
  • Tuberculosis / prevention & control*
  • Tuberculosis / transmission*
  • Young Adult

Substances

  • Antitubercular Agents
  • Isoniazid