Journal
BMJ OPEN
Volume 11, Issue 2, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-040993
Keywords
tuberculosis; community child health; paediatric infectious disease & immunisation
Categories
Funding
- Stop TB Partnership's TB REACH Initiative (Wave 2) - Government of Canada
- University of Massachusetts Office of Global Health Pilot Project program
- National Institute of General Medical Sciences of the National Institutes of Health [U54GM115677]
- Thrasher Research Fund
- Stop TB Partnership's TB REACH Initiative (Wave 5) - Government of Canada
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This study reviewed the child contact management cascade and IPT outcomes in 10 clinics in western Kenya. Among 553 child contacts screened, 42% were reported symptomatic and 13% were diagnosed with active TB disease. 90% of those eligible for IPT initiated treatment, with 58% recorded in the IPT register and 82% documented to complete therapy.
Setting Children especially those <5 years of age exposed to pulmonary tuberculosis (TB) are at a high risk of severe TB disease and death. Isoniazid preventive therapy (IPT) has been shown to decrease disease progression by up to 90%. Kenya, a high TB burden country experiences numerous operational challenges that limit implementation of TB preventive services. IPT completion in child contacts is not routinely reported in Kenya. Objective This study aims to review the child contact management (CCM) cascade and present IPT outcomes across 10 clinics in western Kenya. Design A retrospective chart review of programmatic data of a TB Reach-funded active, clinic-based CCM strategy. Results Of 553 child contacts screened, 231 (42%) were reported symptomatic. 74 (13%) of the child contacts were diagnosed with active TB disease. Of those eligible for IPT, 427 (90%) initiated IPT according to TB REACH project data while 249 (58%) were recorded in the IPT register with 49 (11%) recorded as a transfer to other facilities. Of the 249 recorded in the IPT register, 205 (82%) were documented to complete therapy (48% of project initiation children). Conclusion Our evaluation shows gaps in the routine CCM care cascade related to completeness of documentation that require further programmatic monitoring and evaluation to improve CCM outcomes.
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