Implementing a tuberculosis child contact register to quantify children at risk for tuberculosis and HIV in Eldoret,...

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Pediatric Infectious Diseases

Background:

• Tuberculosis (TB) remains a significant global health challenge, particularly affecting vulnerable populations like children.
• Identifying and managing children exposed to TB is crucial for preventing disease transmission and progression.
• Effective strategies for TB contact tracing and preventive therapy are essential in high-burden settings.

Purpose of the Study:

• To implement and evaluate a child contact register (CCR) for identifying children exposed to TB.
• To assess the demographic characteristics of TB-exposed children.
• To determine the potential for initiating isoniazid preventive therapy (IPT) in this cohort.

Main Methods:

• A child contact register (CCR) was implemented in routine care at a TB clinic in Eldoret, Kenya.
• Healthcare workers actively queried index TB cases about child contacts.
• Data on identified child contacts were retrospectively analyzed.

Main Results:

• The CCR identified 580 children exposed to TB over 12 months.
• 58% were exposed to smear-positive TB, and 30% were under 5 years old.
• Only 1% of child contacts were screened for TB disease, and over 50% of infants born to HIV-positive mothers were not tested for HIV.

Conclusions:

• Implementing a CCR is a feasible, low-resource first step for identifying children at risk of TB and HIV.
• Significant challenges persist in child contact screening and initiating IPT.
• Additional strategies are urgently needed to improve TB prevention and care for exposed children.