Operational challenges in managing Isoniazid Preventive Therapy in child contacts: A highburden setting perspective

van Wyk, Susan S.; Reid, Anthony J.; Mandalakas, Anna M.; Enarson, Donald A.; Beyers, Nulda; Morrison, Julie; Hesseling, Anneke C.
January 2011
BMC Public Health;2011, Vol. 11 Issue 1, p544
Academic Journal
Background: The study was conducted at a high TB-HIV burden primary health community clinic in Cape Town, South Africa. We describe the management of children under five years of age in household contact with a smear and/or culture-positive adult TB case. Methods: This study was a record review of routinely-collected programme data. Results: A total of 1094 adult TB case folders were reviewed. From all identified contacts, 149 children should have received IPT based on local guidelines; in only 2/149 IPT was initiated. Management of child contacts of sputum smear and/or culture-positive compared to sputum-negative TB patients were similar. Conclusions: IPT delivery to children remains an operational challenge, especially in high TB-HIV burden communities. A tool to improve IPT management and targeting sputum smear and/or culture-positive TB child contacts may overcome some of these challenges and should be developed and piloted in such settings.


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