Implementation of isoniazid preventive therapy in children aged under 5 years exposed to tuberculosis in Benin

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 young children.
• Preventive therapy is crucial for reducing TB transmission and disease burden in exposed individuals.
• Integrating preventive strategies into existing national health programs enhances their reach and sustainability.

Purpose of the Study:

• To evaluate the feasibility and outcomes of incorporating isoniazid preventive therapy (IPT) for children under 5 years old into Benin's National TB Programme (NTP).
• To assess the adherence and clinical results of IPT in a real-world, program setting.

Main Methods:

• The study involved children under 5 years old who were household contacts of smear-positive pulmonary TB patients in Benin.
• Children received a medical examination and IPT if no active TB was detected, followed by clinical monitoring for 6 months.
• Data were collected from January 2013 to June 2014.

Main Results:

• Out of 499 notified contacts, 496 children were examined and prescribed IPT.
• An 86% adherence rate to IPT for at least 6 months was achieved.
• Six deaths and three cases of active TB occurred, primarily within the first 3 months of follow-up.

Conclusions:

• Integrating IPT for child contacts into a well-functioning National TB Programme in a moderate TB incidence African country is feasible.
• Simple tools and integration with existing index case management facilitated the program.
• High adherence rates suggest the effectiveness and practicality of this approach for childhood TB prevention.