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Optimising child-friendly TB preventive treatment regimens

C Mulder1,2, A J Bergman3, F Mulatu4

  • 1Department of TB Elimination and Health System Innovations, KNCV Tuberculosis Foundation, The Hague, the Netherlands.

IJTLD Open
|November 17, 2025
PubMed

Insights

The 3HP weekly regimen for tuberculosis preventive treatment (TPT) was preferred over daily 3RH by Ethiopian stakeholders due to lower dosing burden, though pill count remains a concern for improving child TPT adherence.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pediatric Medicine

Background:

  • The World Health Organization (WHO) recommends rifamycin-based TB preventive treatment (TPT) for children.
  • Understanding factors influencing TPT regimen acceptability is crucial for effective implementation.
  • This study explored perceptions of two short-course TPT regimens in Ethiopia.

Purpose of the Study:

  • To assess the acceptability of two short-course TPT regimens (3HP and 3RH) among stakeholders in Ethiopia.
  • To identify factors influencing the choice between weekly (3HP) and daily (3RH) dosing for pediatric TPT.
  • To inform strategies for improving TPT adherence and outcomes in children.

Main Methods:

  • Conducted 47 in-depth interviews with caregivers, health workers, healthcare providers, and policymakers.
  • Utilized thematic content analysis to evaluate regimen acceptability.
  • Focused on factors including palatability, dosing frequency, pill burden, adherence, and side effects.

Main Results:

  • Both 3HP and 3RH regimens were generally well tolerated with mild side effects.
  • Weekly 3HP was perceived as less burdensome but posed adherence challenges (forgetting doses).
  • Daily 3RH presented a higher routine burden for caregivers; 3HP was preferred overall despite pill burden concerns.

Conclusions:

  • Stakeholders favored the 3HP regimen for its reduced dosing frequency.
  • Addressing pill burden and enhancing adherence support are key for successful pediatric TPT.
  • Child-friendly formulations and consideration of patient/caregiver preferences are vital for improving TPT outcomes.
Abstract

Keywords:
EthiopiaTBcaregiversisoniazidpaediatric TBrifampicinrifapentineshort-course regimens

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