Barriers to screening and isoniazid preventive therapy for child contacts of tuberculosis patients

V. Belgaumkar, A. Chandanwale, C. Valvi, G. Pardeshi, R. Lokhande, D. Kadam, S. Joshi, Nikhil Gupte, D. Jain, G. Dhumal, Andrea Deluca, Jonathan E Golub, Amita Gupta, A. Kinikar, Robert C Bollinger

Research output: Contribution to journalArticle

Abstract

BACKGROUND: India's guidelines recommend tuberculosis (TB) screening of household contacts aged,6 years and isoniazid preventive therapy (IPT) for children without active disease. We evaluated the current status and barriers to screening and IPT provision among the child contacts of TB patients. METHODS: Questionnaire and health record data were collected from index cases and health care providers (HCPs) at Sassoon General Hospital, Pune, India. RESULTS: Of 80 adult TB cases, 24 (30%) reported that an HCP recommended TB screening of their child contacts; 49/178 (28%) child contacts were screened. Sixteen (33%) children had active TB, and 28 (85%) of those who screened negative were prescribed IPT. Nineteen (76%) HCPs reported recommending child contact screening. Only 8 (32%) reported ever prescribing IPT. Lack of TB screening and IPT provision for child contacts was associated with inadequate HCP counseling (aOR 19.5, P, 0.001), a non-parent index case (aOR 3.72, P ¼ 0.008) and lack of postgraduate HCP qualification (aOR 19.12, P ¼ 0.04). CONCLUSIONS: TB screening and IPT provision for child contacts of adults with TB were infrequent. Many screened children had active TB. Universal, timely TB screening and IPT for exposed children are urgently needed to reduce pediatric TB in India.

Original languageEnglish (US)
Pages (from-to)1179-1187
Number of pages9
JournalInternational Journal of Tuberculosis and Lung Disease
Volume22
Issue number10
DOIs
StatePublished - Oct 1 2018

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Isoniazid
Tuberculosis
Health Personnel
Therapeutics
India
General Hospitals
Counseling
Guidelines
Pediatrics

Keywords

  • Challenges
  • HCP
  • Pediatric contacts
  • RNTCP guidelines

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Barriers to screening and isoniazid preventive therapy for child contacts of tuberculosis patients. / Belgaumkar, V.; Chandanwale, A.; Valvi, C.; Pardeshi, G.; Lokhande, R.; Kadam, D.; Joshi, S.; Gupte, Nikhil; Jain, D.; Dhumal, G.; Deluca, Andrea; Golub, Jonathan E; Gupta, Amita; Kinikar, A.; Bollinger, Robert C.

In: International Journal of Tuberculosis and Lung Disease, Vol. 22, No. 10, 01.10.2018, p. 1179-1187.

Research output: Contribution to journalArticle

Belgaumkar, V. ; Chandanwale, A. ; Valvi, C. ; Pardeshi, G. ; Lokhande, R. ; Kadam, D. ; Joshi, S. ; Gupte, Nikhil ; Jain, D. ; Dhumal, G. ; Deluca, Andrea ; Golub, Jonathan E ; Gupta, Amita ; Kinikar, A. ; Bollinger, Robert C. / Barriers to screening and isoniazid preventive therapy for child contacts of tuberculosis patients. In: International Journal of Tuberculosis and Lung Disease. 2018 ; Vol. 22, No. 10. pp. 1179-1187.
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abstract = "BACKGROUND: India's guidelines recommend tuberculosis (TB) screening of household contacts aged,6 years and isoniazid preventive therapy (IPT) for children without active disease. We evaluated the current status and barriers to screening and IPT provision among the child contacts of TB patients. METHODS: Questionnaire and health record data were collected from index cases and health care providers (HCPs) at Sassoon General Hospital, Pune, India. RESULTS: Of 80 adult TB cases, 24 (30{\%}) reported that an HCP recommended TB screening of their child contacts; 49/178 (28{\%}) child contacts were screened. Sixteen (33{\%}) children had active TB, and 28 (85{\%}) of those who screened negative were prescribed IPT. Nineteen (76{\%}) HCPs reported recommending child contact screening. Only 8 (32{\%}) reported ever prescribing IPT. Lack of TB screening and IPT provision for child contacts was associated with inadequate HCP counseling (aOR 19.5, P, 0.001), a non-parent index case (aOR 3.72, P ¼ 0.008) and lack of postgraduate HCP qualification (aOR 19.12, P ¼ 0.04). CONCLUSIONS: TB screening and IPT provision for child contacts of adults with TB were infrequent. Many screened children had active TB. Universal, timely TB screening and IPT for exposed children are urgently needed to reduce pediatric TB in India.",
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AU - Belgaumkar, V.

AU - Chandanwale, A.

AU - Valvi, C.

AU - Pardeshi, G.

AU - Lokhande, R.

AU - Kadam, D.

AU - Joshi, S.

AU - Gupte, Nikhil

AU - Jain, D.

AU - Dhumal, G.

AU - Deluca, Andrea

AU - Golub, Jonathan E

AU - Gupta, Amita

AU - Kinikar, A.

AU - Bollinger, Robert C

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N2 - BACKGROUND: India's guidelines recommend tuberculosis (TB) screening of household contacts aged,6 years and isoniazid preventive therapy (IPT) for children without active disease. We evaluated the current status and barriers to screening and IPT provision among the child contacts of TB patients. METHODS: Questionnaire and health record data were collected from index cases and health care providers (HCPs) at Sassoon General Hospital, Pune, India. RESULTS: Of 80 adult TB cases, 24 (30%) reported that an HCP recommended TB screening of their child contacts; 49/178 (28%) child contacts were screened. Sixteen (33%) children had active TB, and 28 (85%) of those who screened negative were prescribed IPT. Nineteen (76%) HCPs reported recommending child contact screening. Only 8 (32%) reported ever prescribing IPT. Lack of TB screening and IPT provision for child contacts was associated with inadequate HCP counseling (aOR 19.5, P, 0.001), a non-parent index case (aOR 3.72, P ¼ 0.008) and lack of postgraduate HCP qualification (aOR 19.12, P ¼ 0.04). CONCLUSIONS: TB screening and IPT provision for child contacts of adults with TB were infrequent. Many screened children had active TB. Universal, timely TB screening and IPT for exposed children are urgently needed to reduce pediatric TB in India.

AB - BACKGROUND: India's guidelines recommend tuberculosis (TB) screening of household contacts aged,6 years and isoniazid preventive therapy (IPT) for children without active disease. We evaluated the current status and barriers to screening and IPT provision among the child contacts of TB patients. METHODS: Questionnaire and health record data were collected from index cases and health care providers (HCPs) at Sassoon General Hospital, Pune, India. RESULTS: Of 80 adult TB cases, 24 (30%) reported that an HCP recommended TB screening of their child contacts; 49/178 (28%) child contacts were screened. Sixteen (33%) children had active TB, and 28 (85%) of those who screened negative were prescribed IPT. Nineteen (76%) HCPs reported recommending child contact screening. Only 8 (32%) reported ever prescribing IPT. Lack of TB screening and IPT provision for child contacts was associated with inadequate HCP counseling (aOR 19.5, P, 0.001), a non-parent index case (aOR 3.72, P ¼ 0.008) and lack of postgraduate HCP qualification (aOR 19.12, P ¼ 0.04). CONCLUSIONS: TB screening and IPT provision for child contacts of adults with TB were infrequent. Many screened children had active TB. Universal, timely TB screening and IPT for exposed children are urgently needed to reduce pediatric TB in India.

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