Implementation of an active, clinic-based child tuberculosis contact management strategy in western Kenya

Area of Science:

• Public Health
• Infectious Diseases
• Pediatrics

Background:

• Tuberculosis (TB) remains a significant cause of mortality in children globally.
• Child contact management (CCM) is recommended by the World Health Organization for high TB burden countries to identify and treat exposed children.
• Effective screening and treatment of child contacts are crucial to reduce TB transmission and disease progression.

Purpose of the Study:

• To describe an active, clinic-based child contact management (CCM) strategy implemented in western Kenya.
• To evaluate the effectiveness of this CCM strategy in screening child contacts aged under 5 years.
• To assess the yield of active TB cases among screened child contacts.

Main Methods:

• Implementation of a clinic-based CCM strategy in western Kenya.
• Strategy components included transport and screening reimbursement, monitoring and evaluation tools, and healthcare worker education.
• Screening was conducted for 169 identified child contacts aged under 5 years.

Main Results:

• A total of 146 out of 169 (86%) identified child contacts underwent successful screening.
• Active TB was diagnosed in 43 out of 146 (29%) of the screened child contacts.
• The implemented CCM strategy demonstrated a high screening completion rate and significant TB case detection.

Conclusions:

• The described active, clinic-based CCM strategy is effective in enhancing the screening of young child contacts in high TB burden settings.
• This approach shows potential for improving TB diagnosis and treatment initiation among vulnerable children.
• Further efforts should focus on scaling up and refining such strategies to combat childhood TB.