dc.contributor.author | Okwara, FN | |
dc.contributor.author | Oyore, JP | |
dc.contributor.author | Were, FN | |
dc.contributor.author | Gwer, S | |
dc.date.accessioned | 2018-01-10T05:18:46Z | |
dc.date.available | 2018-01-10T05:18:46Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | 10.1186/s12879-017-2719-8. | en_US |
dc.identifier.uri | https://www.ncbi.nlm.nih.gov/pubmed/28915796 | |
dc.identifier.uri | http://hdl.handle.net/11295/102293 | |
dc.description.abstract | BACKGROUND:
Sub-Saharan Africa continues to document high pediatric tuberculosis (TB) burden, especially among the urban poor. One recommended preventive strategy involves tracking and isoniazid preventive therapy (IPT) for children under 5 years in close contact with infectious TB. However, sub-optimal effectiveness has been documented in diverse settings. We conducted a study to elucidate correlates to IPT strategy failure in children below 5 years in high burden settings.
METHODS:
A prospective longitudinal cohort study was done in informal settlings in Nairobi, where children under 5 years in household contact with recently diagnosed smear positive TB adults were enrolled. Consent was sought. Structured questionnaires administered sought information on index case treatment, socio-demographics and TB knowledge. Contacts underwent baseline clinical screening exclude TB and/or pre-existing chronic conditions. Contacts were then put on daily isoniazid for 6 months and monitored for new TB disease, compliance and side effects. Follow-up continued for another 6 months.
RESULTS:
At baseline, 428 contacts were screened, and 14(3.2%) had evidence of TB disease, hence excluded. Of 414 contacts put on IPT, 368 (88.8%) completed the 1 year follow-up. Operational challenges were reported by 258(70%) households, while 82(22%) reported side effects. Good compliance was documented in 89% (CI:80.2-96.2). By endpoint, 6(1.6%) contacts developed evidence of new TB disease and required definitive anti-tuberculosis therapy. The main factor associated with IPT failure was under-nutrition of contacts (p = 0.023).
CONCLUSION:
Under-nutrition was associated with IPT failure for child contacts below 5 years in high burden, resource limited settings. IPT effectiveness could be optimized through nutrition support of contacts. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.subject | Children; Failure; Isoniazid; Prevention; Tuberculosis | en_US |
dc.title | Correlates of isoniazid preventive therapy failure in child household contacts with infectious tuberculosis in high burden settings in Nairobi, Kenya - a cohort study. | en_US |
dc.type | Article | en_US |