Assessment of the Isoniazid Preventive Therapy Uptake and Associated Characteristics: A Cross-Sectional Study

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Pediatric Tuberculosis

Background:

• Tuberculosis (TB) remains a significant global health challenge, particularly in high-burden countries.
• Isoniazid preventive therapy (IPT) is a crucial tool for preventing active TB disease in children exposed to infectious TB cases.
• Assessing IPT uptake in vulnerable populations is essential for effective TB control strategies.

Purpose of the Study:

• To evaluate the utilization of isoniazid preventive therapy (IPT) among eligible children in Kigali, Rwanda.
• To identify individual, household, and healthcare system factors influencing IPT uptake.
• To inform strategies for improving TB prevention in pediatric populations.

Main Methods:

• A cross-sectional study design was employed.
• Data were collected from child contacts of sputum smear-positive pulmonary tuberculosis index cases across 13 primary health centers.
• Logistic regression analysis was used to determine factors associated with IPT uptake.

Main Results:

• Out of 270 child contacts, 94 children under 5 years were eligible for IPT, with 89% initiated on therapy.
• Reasons for non-initiation included caregiver lack of information, refusal, and suboptimal healthcare services.
• Factors associated with no IPT uptake were older child age (>3 years), unfriendly healthcare providers, HIV-infected index cases, and non-parental index cases.

Conclusions:

• Rwanda's National Tuberculosis Program policy for IPT delivery demonstrated effective implementation.
• Addressing caregiver awareness, service quality, and specific patient-related factors is crucial for optimizing IPT uptake.
• Future interventions should focus on mitigating identified barriers to ensure comprehensive TB prevention for children.