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Child Contact Management in Tuberculosis under the National Tuberculosis Elimination Program in Kalaburagi District
Poonam Shingade1, Saraswati V Sajjan2, I Amruta Swati3
1Associate Professor, Department of Community Medicine, ESIC Medical College and Hospital, Gulbarga, Karnataka, India.
Insights
India
Area of Science:
- Pediatric infectious diseases
- Public health interventions
- Tuberculosis control programs
Background:
- Tuberculosis (TB) remains a leading cause of child mortality globally.
- India's National TB Elimination Program (NTEP) mandates screening and isoniazid preventive therapy (IPT) for child contacts under 6 years old.
- Effective child contact management (CCM) is crucial for TB prevention in vulnerable populations.
Purpose of the Study:
- To evaluate the implementation of CCM within India's NTEP.
- Assessing the rates of TB screening and IPT initiation among child contacts.
- Identifying factors influencing the success of CCM strategies.
Main Methods:
- A record-based study analyzing data from 192 child contacts and 108 pulmonary TB cases.
- Data collected from January 2019 to December 2020 in rural and urban TB units.
- Information sourced from TB treatment registers and patient cards.
Main Results:
- Screening of child contacts was high (97.9%), but IPT initiation was only 49.4%.
- Lower IPT initiation rates observed in males, younger children, rural populations, and households with multiple child contacts.
- Index cases with comorbidities or addiction were associated with poorer IPT initiation for child contacts.
Conclusions:
- While TB screening in child contacts is effective under NTEP, IPT initiation rates are suboptimal.
- Significant gaps exist in ensuring preventive therapy for eligible children.
- Improved strategies and tools are urgently needed to enhance IPT initiation and strengthen CCM under NTEP.
Background:
Tuberculosis (TB) is one of the major causes of mortality among children globally. Considering the vulnerability of children, India's National TB Elimination Program (NTEP) recommends screening of all household contacts aged <6 years for TB and initiates 6-month isoniazid preventive therapy (IPT).
Objectives:
The objective of the study was to assess the child contact management (CCM) in terms of screening and initiation of IPT under NTEP.
Materials And Methods:
This record-based study has included 192 child contacts and 108 pulmonary TB cases registered from January 2019 to December 2020 from two randomly selected TB units, one each from rural and urban area. The data were obtained from TB treatment registers and TB treatment cards from the district TB office.
Results:
Most of the children were in the age group of 2-4 years, belonging to rural area and below poverty line families. Although screening of the child contacts was good (97.9%), IPT was initiated in only 49.4% of the screened children. Initiation of IPT was found to be low among males, relatively younger children, and rural population. Lower rates of initiation of IPT were also noted among the children with male index cases, those who are aged ≥45 years, and also among households with more than one child contact. Poor initiation rates were found among the children for whom the index cases presented with any of the comorbidity and addiction.
Conclusion:
CCM under NTEP is repeatedly emphasized for decades together. Although the percentage of screening was good (97.9%), the initiation of IPT was found, nearly only half of the children which emphasizes the need for the effective strategies and tools to improve the same under the program.
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