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An open-label cluster-randomised trial on TB preventive therapy for children
IJTLD Open
|March 17, 2025
Summary
Shorter tuberculosis preventive therapy using rifampicin and isoniazid (RH) for 4 months did not improve adherence in children compared to 9 months of isoniazid (INH). Travel was the main reason for missed doses in both groups.
Area of Science:
- Pediatric infectious diseases
- Public health interventions
- Tuberculosis control
Background:
- Previous studies showed suboptimal adherence to 9-month isoniazid preventive therapy (IPT) in children exposed to TB.
- Adherence rates for 6-month IPT in children in Guinea-Bissau were 76%.
Purpose of the Study:
- To compare adherence rates between 4-month rifampicin and isoniazid (RH) therapy and 9-month isoniazid (INH) therapy in children exposed to TB.
- To determine if a shorter RH regimen improves treatment completion in pediatric TB contact management.
Main Methods:
- An open-label, cluster-randomised superiority study was conducted in children under 15 years old living with a TB case.
- Participants were randomized by house to receive either 4 months of RH (fixed-combination pill) or 9 months of INH.
- Adherence was defined as taking >80% of prescribed dosages per month, assessed by pill count.
Main Results:
- A total of 752 children were included; 57% adhered to treatment (>80% pills taken).
- Adherence was 68% for 6 months of INH versus 61% for 3 months of RH (OR 1.32, 95% CI 0.90-1.95).
- The primary reason for non-adherence in both groups was travel or relocation, accounting for 50% of missed doses.
Conclusions:
- Four months of RH preventive therapy did not improve adherence in children in Guinea-Bissau compared to 9 months of INH.
- Travel and relocation were identified as the main barriers to adherence in pediatric TB preventive therapy.
Keywords:
barriers of adherencechildrenisoniazid preventive therapyprevention and controltuberculosisMore Related Videos
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