Uptake of Tuberculosis Preventive Therapy Among Eligible Children Under Five Years in Mombasa County

Abstract

Background: In 2018, 10 million people were diagnosed with TB out of which 1.5 million died.Children consisted 11% of this population.Kenya is ranked in the top 30 globally for high TB endemicity.Tuberculosis preventive treatment reduces the risk of a child contracting active TB by 60%. Worldwide, only 27% of children under 5 years eligible for TB preventive treatment were started on it despite clear evidence that it reduces morbidity by 72% and mortality by 54%. In Kenya, TB preventive treatment of children below five yearswith household contact of bacterialogicallydiagnosed TB cases coverage was at 34% in 2018.This is clear evidence that uptake of TB preventive therapy by eligible children is reduced and its implementation remains difficult.Mombasa is among the top 10 counties that contributed to half of the TB cases (ranking second) and TB related deaths in Kenya. Objectives:To determine uptake of TB preventive therapy among eligible children under five years who are household contacts of bacteriologically confirmed pulmonary TB index cases in Mombasa: Coast Provincial General Hospital, Port Reitz Sub-County Hospital, Ganjoni Dispensary and Likoni Subcounty Hospital.To assess the knowledge, attitude and practice of health workers regarding TB preventive therapy in eligible children under 5 years in these hospitals and possible barriers with regard to TPT. Study Site: The research was undertaken in Mombasa county, in the Coastal region of KenyaThe facilities in which the study was undertaken wereCoast Provincial General Hospital, Port Reitz Sub-County Hospital, Ganjoni Dispensary and Likoni Subcounty Hospital in their respective TB clinics Study design: Mixed methods. Methods: This was a mixed methods research combining both qualitative and quantitative using structured questionnares with both open ended and closed ended questions. Consecutive sampling of bacteriologically confirmed TB index cases having received at least 4 weeks of treatment and living with a child under 5 years, was used to acquire the150 sample size of under five years eligible children per index case. Questionnaires were administered to recruited index...........................................................