Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali

BACKGROUND and OBJECTIVE: Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged 15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali.METHODS: Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months.RESULTS: A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0–4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events.CONCLUSION: We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.

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Tuberculosis contact investigation results among paediatric contacts in low-incidence settings in Finland

European Journal of Pediatrics ◽

10.1007/s00431-021-04000-7 ◽

2021 ◽

Author(s):

Antti Kontturi ◽

Satu Kekomäki ◽

Eeva Ruotsalainen ◽

Eeva Salo

Keyword(s):

Early Diagnosis ◽

Young Children ◽

Large Scale ◽

Index Case ◽

Contact Tracing ◽

Sputum Smear ◽

Endemic Country ◽

Household Contacts ◽

Contact Investigation ◽

Positive Index

AbstractTuberculosis (TB) risk is highest immediately after primary infection, and young children are vulnerable to rapid and severe TB disease. Contact tracing should identify infected children rapidly and simultaneously target resources effectively. We conducted a retrospective review of the paediatric TB contact tracing results in the Hospital District of Helsinki and Uusimaa from 2012 to 2016 and identified risk factors for TB disease or infection. Altogether, 121 index cases had 526 paediatric contacts of whom 34 were diagnosed with TB disease or infection. The maximum delay until first contact investigation visit among the household contacts under 5 years of age with either TB disease or infection was 7 days. The yield for TB disease or infection was 4.6% and 12.8% for household contacts, 0.5% and 0% for contacts exposed in a congregate setting and 1.4% and 5.0% for other contacts, respectively. Contacts born in a TB endemic country (aOR 3.07, 95% CI 1.10–8.57), with household exposure (aOR 2.96, 95% CI 1.33–6.58) or a sputum smear positive index case (aOR 3.96, 95% CI 1.20–13.03) were more likely to have TB disease or infection.Conclusions: Prompt TB investigations and early diagnosis can be achieved with a well-organised contact tracing structure. The risk for TB infection or disease was higher among contacts with household exposure, a sputum smear positive index case or born in a TB endemic country. Large-scale investigations among children exposed in congregate settings can result in a very low yield and should be cautiously targeted. What is Known:• Vulnerable young children are a high priority in contact tracing and should be evaluated as soon as possible after TB exposure What is New:• Prompt investigations for paediatric TB contacts and early diagnosis of infected children can be achieved with a well-organised contact tracing structure• Large-scale investigations among children exposed in congregate settings can result in a very low yield and should be cautiously targeted

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Improving coverage and completion rate of isoniazid preventive therapy among eligible HIV patients using quality improvement approaches: a case study of State Hospital, Ijebu Ode, Ogun State, Nigeria

Pan African Medical Journal ◽

10.11604/pamj.2019.34.193.19360 ◽

2019 ◽

Vol 34 ◽

Author(s):

Olabanjo Okunlola Ogunsola ◽

Oluseye Ajayi ◽

Omobola Ojo ◽

Oluwatomisin Adeyeye ◽

Yewande Akinro ◽

...

Keyword(s):

Quality Improvement ◽

State Hospital ◽

Preventive Therapy ◽

Completion Rate ◽

Isoniazid Preventive Therapy ◽

Hiv Patients ◽

Ogun State

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Adverse events with isoniazid preventive therapy: experience from a large trial

AIDS ◽

10.1097/01.aids.0000391019.10661.66 ◽

2010 ◽

Vol 24 (Suppl 5) ◽

pp. S29-S36 ◽

Cited By ~ 26

Author(s):

Alison D Grant ◽

Kathryn T Mngadi ◽

Clare L van Halsema ◽

Mariëtha M Luttig ◽

Katherine L Fielding ◽

...

Keyword(s):

Adverse Events ◽

Preventive Therapy ◽

Isoniazid Preventive Therapy ◽

Large Trial

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Intensity of exposure to pulmonary tuberculosis determines risk of tuberculosis infection and disease

European Respiratory Journal ◽

10.1183/13993003.01578-2017 ◽

2018 ◽

Vol 51 (1) ◽

pp. 1701578 ◽

Cited By ~ 17

Author(s):

Carlos Acuña-Villaorduña ◽

Edward C. Jones-López ◽

Geisa Fregona ◽

Patricia Marques-Rodrigues ◽

Mary Gaeddert ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Diagnostic Performance ◽

Index Case ◽

Disease Risk ◽

Preventive Therapy ◽

Measured Intensity ◽

Household Contacts ◽

Increased Risk ◽

Sleep Location ◽

Index Cases

Household contacts of pulmonary tuberculosis (TB) patients are at increased risk of TB infection and disease. However, their risk in relation to the intensity of exposure remains unknown.We studied smear-positive TB cases and their household contacts in Vitória, Brazil. We collected clinical, demographic and radiographic information from TB cases, and obtained tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) results from household contacts. We measured intensity of exposure using a proximity score and sleep location in relation to the TB index case and defined infection by TST ≥10 mm or QFT ≥0.35 UI·mL−1. We ascertained secondary TB cases by reviewing local and nationwide case registries.We included 160 TB index cases and 894 household contacts. 464 (65%) had TB infection and 23 (2.6%) developed TB disease. Risk of TB infection and disease increased with more intense exposures. In an adjusted analysis, the proximity score was associated with TB disease (OR 1.61, 95% CI 1.25–2.08; p<0.000); however, its diagnostic performance was only moderate.Intensity of exposure increased risk of TB infection and disease among household contacts; however, its diagnostic performance was still suboptimal. A biomarker to target preventive therapy is urgently needed in this at-risk population.

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