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Adherence to isoniazid preventive therapy in Indonesian children: A quantitative and qualitative investigation

Merrin E Rutherford1, Rovina Ruslami, Winni Maharani

  • 1Centre for International Health, University of Otago, Dunedin, New Zealand. merrin.rutherford@gmail.com.

BMC Research Notes
|January 7, 2012
PubMed

Insights

Isoniazid preventive therapy (IPT) adherence is very low in Indonesian children under five, with cost and access being major barriers. Addressing these issues is crucial for reducing childhood tuberculosis.

Area of Science:

  • Public Health
  • Pediatric Infectious Diseases
  • Tuberculosis Control

Background:

  • Isoniazid preventive therapy (IPT) is recommended for child contacts of infectious tuberculosis cases.
  • Low reported adherence to IPT in children is a significant public health concern.
  • Risk factors for poor IPT adherence in pediatric populations remain largely uncharacterized.

Purpose of the Study:

  • To determine IPT adherence rates in children under five years old in an Indonesian lung clinic.
  • To identify risk factors associated with poor IPT adherence in this pediatric cohort.
  • To explore caregiver-reported barriers to IPT adherence through qualitative methods.

Main Methods:

  • Prospective study of children under five receiving IPT.
  • Logistic regression analysis to identify risk factors for adherence (defined as ≤3 months prescription collection).
  • In-depth interviews with caregivers of children with both good and poor adherence.

Main Results:

  • 74.4% of 82 eligible children exhibited poor IPT adherence.
  • High transport costs (OR 3.3) and medication costs (OR 20.0) were significantly associated with poor adherence.
  • Qualitative analysis revealed access, medication issues, health service experiences, and caregiver knowledge as key determinants.

Conclusions:

  • Childhood IPT adherence in this Indonesian setting is extremely low.
  • Financial, knowledge, health service, and medication-related barriers contribute to poor adherence.
  • Evidence-based interventions targeting these barriers are essential for effective childhood tuberculosis reduction.
Abstract

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