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Adherence to isoniazid preventive chemotherapy: a prospective community based study.
B J Marais1, Susan van Zyl, H S Schaaf
1Desmond Tutu TB Centre and Department of Paediatrics and Child Health, Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa. bjmarais @sun.ac.za
Archives of Disease in Childhood
|June 2, 2006
Summary
Adherence to unsupervised isoniazid preventive therapy in children exposed to tuberculosis was poor, with only 20% completing the recommended six-month regimen. This highlights the need for improved strategies to ensure children receive effective tuberculosis prevention.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- International guidelines recommend 6-9 months of isoniazid (INH) preventive chemotherapy for children exposed to tuberculosis.
- Adherence to unsupervised INH preventive chemotherapy is often poor, potentially impacting its effectiveness.
Purpose of the Study:
- To prospectively assess adherence to a six-month unsupervised INH monotherapy regimen.
- To document the outcomes in children with household exposure to an adult pulmonary tuberculosis index case.
Main Methods:
- Children under 5 years old with household exposure to an adult pulmonary tuberculosis case were screened.
- Eligible children received unsupervised INH preventive chemotherapy; adherence and outcomes were monitored.
Main Results:
- Of 180 children receiving preventive chemotherapy, only 36 (20%) completed at least five months of unsupervised INH.
- Six children developed active tuberculosis during follow-up; four of these had very poor adherence to INH.
Conclusions:
- Adherence to unsupervised six-month INH preventive chemotherapy in children is suboptimal.
- Improved adherence strategies, such as shorter multidrug regimens or supervised treatment, warrant further investigation for high-risk children.