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[Antituberculosis chemoprophylaxis in a public hospital - study of 100 children]

Clemax C. Sant'Anna1, Solange G. David, Anna M. Marques

  • 1Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.

Jornal De Pediatria
|December 3, 2003
PubMed

Insights

This study evaluated tuberculosis chemoprophylaxis in children, finding that while 15% adhered to guidelines, 85% were prescribed treatment for high-risk groups. Adherence to national guidelines for pediatric tuberculosis prevention needs improvement.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Antituberculosis chemoprophylaxis is crucial for preventing active tuberculosis in children, especially those exposed to infected individuals or with specific risk factors.
  • National guidelines aim to standardize chemoprophylaxis, but adherence and effectiveness in diverse pediatric populations require evaluation.
  • Special considerations exist for very young children, BCG-vaccinated children with positive tuberculin skin tests, and those with recent or current exposure to tuberculosis.

Purpose of the Study:

  • To assess the adherence to National Tuberculosis Control Program guidelines for antituberculosis chemoprophylaxis in children.
  • To evaluate the application of these recommendations in special pediatric situations, including high-risk groups.
  • To analyze factors influencing chemoprophylaxis outcomes, such as adherence, monotherapy failure, and side effects.

Main Methods:

  • A retrospective cross-sectional study was conducted on 100 children receiving chemoprophylaxis at a public hospital in Rio de Janeiro.
  • Data collected included demographics, BCG vaccination status, nutritional status, tuberculin skin test results, tuberculosis exposure, and treatment adherence.
  • Analysis focused on adherence to guidelines, identification of infection sources, monotherapy failure rates, and isoniazid side effects.

Main Results:

  • The study included 57% males and 43% females; 62% were under five years old.
  • 92% had prior BCG vaccination, 28% presented with malnutrition, and 9% were recent tuberculosis converters.
  • Parents were the source of infection in 60% of known cases; 73% adhered to chemoprophylaxis, with 1% experiencing monotherapy failure and 1% reporting isoniazid side effects.

Conclusions:

  • Only 15% of children fully followed Health Department guidelines, including those with recent tuberculosis converters.
  • The majority (85%) of recommended chemoprophylaxis was administered to cover high-risk pediatric groups.
  • Findings suggest a need to improve adherence to established national guidelines for pediatric tuberculosis chemoprophylaxis, particularly for vulnerable populations.

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