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Implementation of an integrated care strategy for child contacts of tuberculosis patients: a quasi-experimental study
Dione Benjumea-Bedoya1,2,3, Esteban Villegas Arbeláez4, Daniela Martínez-Peñaloza4
1Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia. dionebenjumea@gmail.com.
Insights
This study introduces an integrated care strategy for children under five years old who are household contacts of tuberculosis patients. The approach aims to improve treatment adherence and outcomes for latent tuberculosis in children.
Area of Science:
- Public Health
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Childhood tuberculosis remains a significant global public health challenge.
- Increased visibility of childhood tuberculosis necessitates further research into effective interventions.
- Household contacts of tuberculosis patients are at high risk for developing the disease.
Purpose of the Study:
- To design, implement, and evaluate an integrated care strategy for children under five years old who are household contacts of pulmonary tuberculosis patients.
- To assess the effectiveness of a modified rifampicin-based treatment regimen for latent tuberculosis in this vulnerable population.
- To compare the outcomes of the integrated care strategy with the standard isoniazid treatment.
Main Methods:
- A quasi-experimental study involving approximately 300 children under five years old identified as household contacts.
- Implementation of an integrated care strategy including modified rifampicin treatment (4 months), multidisciplinary follow-up, and logistical support (transportation, food assistance).
- Comparison of the integrated strategy with a historical cohort receiving standard isoniazid treatment (2015-2018).
Main Results:
- The study is ongoing; results are pending.
- The integrated care strategy is designed to enhance treatment compliance and reduce barriers to care.
- Expected outcomes include improved management of latent tuberculosis in children and contribution to global tuberculosis control efforts.
Conclusions:
- The development of innovative, integrated care strategies is crucial for managing childhood tuberculosis.
- This research is expected to provide valuable insights into optimizing treatment adherence and outcomes for children at high risk.
- Findings will contribute to achieving the World Health Organization's End TB Strategy goals.
Background:
Childhood tuberculosis continues to be a major public health problem. Although the visibility of the epidemic in this population group has increased, further research is needed.
Objective:
To design, implement and evaluate an integrated care strategy for children under five years old who are household contacts of bacteriologically confirmed pulmonary tuberculosis patients in Medellín and the Metropolitan Area.
Methods:
A quasi-experimental study in which approximately 300 children who are household contacts of bacteriologically confirmed pulmonary tuberculosis patients from Medellín and the Metropolitan Area will be evaluated and recruited over one year. A subgroup of these children, estimated at 85, who require treatment for latent tuberculosis, will receive an integrated care strategy that includes: some modifications of the current standardized scheme in Colombia, with rifampicin treatment daily for four months, follow-up under the project scheme with nursing personnel, general practitioners, specialists, professionals from other disciplines such as social work, psychology, and nutritionist. Additionally, transportation and food assistance will be provided to encourage treatment compliance. This strategy will be compared with isoniazid treatment received by a cohort of children between 2015 and 2018 following the standardized scheme in the country. The study was approved by the CIB Research Ethics Committee and UPB.
Clinicaltrials:
gov identifier NCT04331262.
Discussion:
This study is expected to contribute to the development of integrated care strategies for the treatment of latent tuberculosis in children. The results will have a direct impact on the management of childhood tuberculosis contributing to achieving the goals proposed by the World Health Organization's End TB Strategy.
Trial Registration:
ClinicalTrials.gov identifier NCT04331262 . Implementation of an Integrated Care Strategy for Children Contacts of Patients with Tuberculosis. Registered 2 April 2020.
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