scholarly journals Management of Isoniazid Preventive Therapy in Southern Lima, Peru: An Analysis of Health Center Characteristics

2021 ◽  
Author(s):  
Roberto Zegarra-Chapoñan ◽  
Lily Victoria Bonadonna ◽  
Courtney M. Yuen ◽  
Martha Brigida Martina-Chávez ◽  
Jhon Zeladita
Keyword(s):  
Health Center ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
Health Centers ◽  
Isoniazid Preventive Therapy ◽  
Tuberculosis Patients ◽  
Children And Adolescent ◽  
Clinical Evaluations ◽  
Critical Activity

Abstract Background: Prevention of TB through the use of preventive treatment is a critical activity in the elimination of TB. Health personnel are a key element in achieving proper management of isoniazid preventive therapy (IPT) for TB contacts. This study aims to determine the association between health center characteristics and indicators of TB contact care management with isoniazid preventive therapy in southern Lima. Methods: We conducted an ecological study. Through the review of medical records, we identified children and adolescent contacts of tuberculosis patients, who initiated IPT between 2016 and 2018. We assessed bivariate associations between clinic staffing and IPT initiation and completion using binomial logistic regression with robust standard errors.Results: We included 977 contacts, among whom 69% took more than a week to start IPT and 41% did not complete IPT. For those who did successfully complete IPT, 58% were not medically evaluated with three follow-up appointments. While completion of IPT and 3 clinical appointments was better among health centers with more physicians and nurses, these differences were not statistically significant. Contact sex was associated with initiating IPT (p=0.005), and contact age was associated with completion of IPT (p=0.025) and completion of clinical evaluations (p=0.041). Conclusion: There are significant gaps in IPT management in health centers of southern Lima, Peru, but insufficient staffing of health centers may not be responsible. Further research is needed to identify how IPT management can be improved, including through improving training and staffing.

scholarly journals Implementation of isoniazid preventive therapy in southern Lima, Peru: an analysis of health center characteristics

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Roberto Zegarra-Chapoñan ◽  
Lily Victoria Bonadonna ◽  
Courtney M. Yuen ◽  
Martha Brigida Martina-Chávez ◽  
Jhon Zeladita-Huaman
Keyword(s):  
Health Center ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
Health Centers ◽  
Isoniazid Preventive Therapy ◽  
Clinical Evaluations ◽  
Significant Difference ◽  
Service Type ◽  
Critical Activity

Abstract Background Tuberculosis (TB) prevention through the use of preventive treatment is a critical activity in the elimination of TB. In multiple settings, limited staffing has been identified as a barrier to managing preventive treatment for TB contacts. This study aims to determine how health center staffing, service type, and TB caseload affects implementation of isoniazid preventive therapy (IPT) for TB contacts in southern Lima. Methods We conducted an ecological study in 2019 in southern Lima, Peru. Through the review of medical records, we identified contacts of TB patients who initiated IPT during 2016–2018, and who were 0–19 years old, the age group eligible for IPT according to Peruvian guidelines. We assessed bivariate associations between health center characteristics (numbers of physicians and nurses, types of services available, annual TB caseload) and IPT initiation and completion using binomial logistic regression. Results Among 977 contacts, 69% took more than a week to start IPT and 41% did not complete IPT. For those who successfully completed IPT, 58% did not complete full medical follow-up. There was no significant difference in IPT completion or adherence based on whether health centers had more physicians and nurses, more comprehensive services, or higher TB caseloads. Among contacts, female sex was associated with delay in initiating IPT (P = 0.005), age 5–19 years old was associated with completion of IPT (P = 0.025) and age < 5 years old was associated with completion of clinical evaluations (P = 0.041). Conclusions There are significant gaps in IPT implementation in health centers of southern Lima, Peru, but insufficient staffing of health centers may not be responsible. Further research is needed to identify how IPT implementation can be improved, potentially through improving staff training or monitoring and supervision. Graphic abstract

scholarly journals Effect of Isoniazid Preventive Therapy on the Incidence of Tuberculosis among Seropositive Children Attending HIV/AIDS Care in Two General Hospitals, Northwest Ethiopia, 2021

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Fassikaw Kebede ◽  
Birhanu Kebede ◽  
Tsehay Kebede ◽  
Melaku Agmasu
Keyword(s):  
Cox Regression ◽  
Data Entry ◽  
Concomitant Administration ◽  
Preventive Therapy ◽  
Northwest Ethiopia ◽  
Isoniazid Preventive Therapy ◽  
Categorical Variables ◽  
P Value ◽  
Human Immune Deficiency Virus

The human immune deficiency virus (HIV) is the strongest risk factor for the incidence of tuberculosis (TB) by way of reactivation of latent or new infection. The provision of isoniazid preventive therapy (IPT) is one of the public health interventions for the prevention of TB. To date, there have been limited clinical data regarding the effectiveness of isoniazid preventive therapy (IPT) on TB incidence. This study aimed to assess the effect of isoniazid preventive therapy on the incidence of tuberculosis for seropositive children in Northwest Ethiopia. Methods. A facility-based retrospective follow-up was employed for reviewing 421 files from 1 January 2015 up to 30 December 2019. EpiData version 3.2 and Stata/14 software were used for data entry and analysis, respectively. Categorical variables at bivariable Cox regression were assessed for candidates transferred at P value <0.25 for multivariable Cox regression to claiming predictors associated with TB incidence rate at 95% CI at P < 0.005 . Result. The overall incidence of TB was found to be 4.99 cases per 100 person-years at 95% CI (3.89–6.53). Missed IPT (AHR = 7.45, 95% CI: 2.96, 18.74, P < 0.001 ), missed cotrimoxazole preventive therapy (CPT) (AHR = 2.4, 95% CI: 1.84–4.74, P < 0.022 ), age ≥ 11 years (AHR = 4.2, 95% CI: 1.04–7.03, P < 0.048 ), MUAC ≤ 11.5 cm (AHR = 4.36, 95% CI: 1.97–9.97, P < 0.001 ), WHO stages III and IV (AHR = 2.04, 95% CI: 1.12–3.74, P < 0.022 ), and CD4 count ≤100 cells/μl (AHR = 3.96, 95% CI: 1.52–10.34, P < 0.005 ) were significantly associated with TB incidence. Conclusion. Concomitant administration of ART with IPT had demoted more than ninety-six percent of new TB incidences for this report. Undertaking in-depth TB screening and frequent follow-up among all these children is critical in order to prevent and control tuberculosis.

Serial T-SPOT.TB in household contacts of tuberculosis patients: a 6-year observational study in China

2019 ◽  
Vol 23 (9) ◽  
pp. 989-995 ◽  
Author(s):  
H-C. Zhang ◽  
Q-L. Ruan ◽  
J. Wu ◽  
S. Zhang ◽  
S-L. Yu ◽  
...  
Keyword(s):  
Observational Study ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
Interferon Gamma Release Assay ◽  
Household Contacts ◽  
Conversion Rates ◽  
Ltbi Prevalence ◽  
Release Assay ◽  
Latent Tb Infection

BACKGROUND: Screening tuberculosis (TB) contacts is a priority for TB control; however, it remains inadequate in most regions of China.OBJECTIVE: To investigate the progression of latent TB infection (LTBI) using the interferon-gamma release assay (IGRA) in contacts of active TB patients.DESIGN: This longitudinal prospective observational study included 159 household contacts aged ≥14 years without preventive treatment who were followed up for 6 years to compare their conversion and reversion rates using the T-SPOT®.TB IGRA to diagnose LTBI.RESULTS: Among the 159 household contacts, LTBI positivity was 47.5%. Age was independently associated with LTBI (OR 3.6, 95%CI 1.81–7.14; P = 0.00). T-SPOT.TB conversion rates were respectively 29.4% and 18.8% at 3- and 6-year follow-up. The reversion rates were 9.4% of contacts during the 3-year follow-up period, which increased to 38.2% at the 6-year follow-up. A decreasing trend in spot-forming cells on T-SPOT.TB was observed in most patients at the 6-year follow-up.CONCLUSION: LTBI prevalence among household contacts was relatively high, particularly in elderly patients. Furthermore, serial IGRA testing was highly dynamic; however, this overall trend gradually decreased over time, even if preventive therapy was not prescribed.

scholarly journals Pendampingan Kader Puskesmas Dalam Pengelolaan Limbah Rumah Tangga Sebagai Kompos

2020 ◽  
Vol 4 (4) ◽  
pp. 643-648
Author(s):  
Maksuk ◽  
Lukman
Keyword(s):  
Public Health ◽  
Health Center ◽  
Community Health Centers ◽  
Health Workers ◽  
Health Centers ◽  
Household Waste ◽  
Bank Managers ◽  
Working Groups ◽  
Waste Bank

The cadres of public health center  have an important role in managing of households in the community, therefore it is important to improve skills to manage such waste so that the waste can be utilized and beneficial. The method of managing household waste in this activity uses the concept of Pilah – Kumpul - Manfaat - Untung (PKMU) to reduce the volume of household waste and provide benefits to the community. Participants involved in this activity were health workers, kader of community health centers and the community of RT 14 and RT 33. The Achievement targets in this activity were to improve the ability of health workers and cadres to manage of household waste, use of household waste for the planting of medicinal plants, families and the formation of independent care working groups for batra activities in health center and the formation of waste bank managers. The results of this activity show that cadres and the community can use household waste as compost, in addition, household waste such as plastic can be reused. The follow up of this activity is the formation of a waste bank manager at the location of the activity.

scholarly journals Adherence to Isoniazid Preventive Therapy among Under-Five Children in Contact with Adult Bacteriologically Confirmed Pulmonary Tuberculosis Patients: A Mixed-Method Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Getachew Seid ◽  
Tsegaye Tsedalu ◽  
Marta Ayele ◽  
Faham Khamesipour
Keyword(s):  
Pulmonary Tuberculosis ◽  
World Health Organization ◽  
Study Design ◽  
Addis Ababa ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
World Health ◽  
Tuberculosis Patients ◽  
The World ◽  
Health Organization

Background. The World Health Organization recommends that all children below the age of five who have household contact with an infectious tuberculosis case should receive isoniazid preventive treatment for at least six months after the active tuberculosis disease has been ruled out. This research aims to determine the adherence of children, eligible for isoniazid preventive treatment, to the treatment who had contact with pulmonary tuberculosis patients. Methods. A mixed study design was used to prospectively assess the adherence to IPT among children under the age of 5 in contact with pulmonary TB patients through the quantitative study design and barriers of adherence in view of health care professionals and the family of children through a descriptive qualitative study. The study was conducted from July 2019 to December 2019 in Addis Ababa. Data were collected by a structured datasheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants. Result. The ratio of the total number of pulmonary tuberculosis index cases recruited into the study to the number of child contacts aged less than 5 years was 1 : 1.32. The total isoniazid preventive treatment uptake in this study was 75.2%; one-fifth (21.3%) of the children who started IPT did not complete the full course of six-month isoniazid preventive treatment. Except for HIV not to be tested ( P < 0.001 ), there was no significant association of the listed risk factors in default to complete the full six months of preventive treatment. Conclusion. Enrolment of eligible children for isoniazid preventive treatment in the urban city Addis Ababa was still below the target of the World Health Organization End tuberculosis strategy by 2030. The treatment adherence rate also needs a great deal of effort to achieve the strategy. Child default after the first visit indicates a lack of understanding about the benefit and safety of preventive therapy in young children among families of TB patients, and awareness-creating efforts by health extension workers will help to improve the outcomes.

Is Continuity of Care Preserved in Children Who Utilize the Pediatric Emergency Department?

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 37-41
Author(s):  
Patrick M. Vivier ◽  
William J. Lewander ◽  
Stanley H. Block ◽  
Peter R. Simon ◽  
Anthony J. Alario ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Inner City ◽  
Health Center ◽  
Continuity Of Care ◽  
Pediatric Emergency ◽  
Health Centers ◽  
Pediatric Emergency Department ◽  
Primary Care Site

Objective. Inner city families often use multiple sites for nonemergent medical care, including the pediatric emergency department. This practice raises concerns about continuity of care. The present study examined one aspect of continuity of care: Do children who receive care in a pediatric emergency department return to their primary care site so that appropriate follow up may be obtained? Methods. Over a 4-week period two groups of neighborhood health center children were studied: Those who sought care at the pediatric emergency department and those who were "walk-ins" at the health centers. All visits during the 4-week study period which resulted in a recommendation for the child to be seen within 6 weeks at the health centers were included in the analysis. Results. During the study period there were 87 patient visits to the pediatric emergency department with a documented physician instruction to be seen at their health center within 6 weeks. In 66 (76%) of the cases, the patient was seen at one of the health centers during the 6 weeks following the pediatric emergency department visit. There were 146 "walk-in" visits to the health centers with a documented physician instruction to be seen again at the health centers during the 6 weeks following the walk-in visit. In 111 (76%) of the cases, the patient was seen during the 6-week period. Conclusion. Our study shows that revisit rates were comparable for the two groups. We conclude that the rate of compliance with follow-up recommendations is similar for those who utilized the pediatric emergency department versus those who used the primary care site.

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