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Tuberculosis contact screening and isoniazid preventive therapy in a South Indian district: operational issues for programmatic consideration.

Pothukuchi M, Nagaraja SB, Kelamane S, Satyanarayana S - PLoS ONE (2011)

Bottom Line: Of them, 116 (67%) were evaluated for TB disease; none were found to be TB diseased and 97 (84%) contacts were initiated on IPT and 19 (16%) contacts were not initiated on IPT due to shortage of INH tablets in peripheral health centers.Contact screening and IPT implementation under routine programmatic conditions is sub-optimal.There is an urgent need to sensitize all concerned programme staff on its importance and establishment of mechanisms for rigorous monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Medicine, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.

ABSTRACT

Background: Under India's Revised National Tuberculosis Control Programme (RNTCP), all household contacts of sputum smear positive Pulmonary Tuberculosis (PTB) patients are screened for TB. In the absence of active TB disease, household contacts aged <6 years are eligible for Isoniazid Preventive Therapy (IPT) (5 milligrams/kilogram body weight/day) for 6 months.

Objectives: To estimate the number of household contacts aged <6 years, of sputum smear positive PTB patients registered for treatment under RNTCP from April to June'2008 in Krishna District, to assess the extent to which they are screened for TB disease and in its absence initiated on IPT.

Methods: A cross sectional study was conducted. Households of all smear positive PTB cases (n = 848) registered for treatment from April to June'2008 were included. Data on the number of household contacts aged <6 years, the extent to which they were screened for TB disease, and the status of initiation of IPT, was collected.

Results: Households of 825 (97%) patients were visited, and 172 household contacts aged <6 years were identified. Of them, 116 (67%) were evaluated for TB disease; none were found to be TB diseased and 97 (84%) contacts were initiated on IPT and 19 (16%) contacts were not initiated on IPT due to shortage of INH tablets in peripheral health centers. The reasons for non-evaluation of the remaining eligible children (n = 56, 33%) include no home visit by the health staff in 25 contacts, home visit done but not evaluated in 31 contacts. House-hold contacts in rural areas were less likely to be evaluated and initiated on IPT [risk ratio 6.65 (95% CI; 3.06-14.42)].

Conclusion: Contact screening and IPT implementation under routine programmatic conditions is sub-optimal. There is an urgent need to sensitize all concerned programme staff on its importance and establishment of mechanisms for rigorous monitoring.

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Related in: MedlinePlus

Contact Screening and IPT provision to childhood contacts of sputum smear positive PTB Patients, Krishna District, South India.
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pone-0022500-g001: Contact Screening and IPT provision to childhood contacts of sputum smear positive PTB Patients, Krishna District, South India.

Mentions: The 825 TB patients included 628 (76%) men and 197 (24%) women. The mean age of the smear positive TB patients was 46 years (Standard deviation 15.8 years).There were a total of 172 children <6 years of age who were determined to be household contacts (Table 1). The ratio of smear positive PTB patients to child contacts below 6 years was found to be 5∶1. Of the total contacts, 116 (67.5%) contacts were screened for TB disease, none were found to have TB disease, and 97 (84%) of them were on IPT (Figure 1). Out of the 97 children who were initiated on IPT, 83 (85.5%) children were consuming Isoniazid tablets regularly as outlined under the programme.


Tuberculosis contact screening and isoniazid preventive therapy in a South Indian district: operational issues for programmatic consideration.

Pothukuchi M, Nagaraja SB, Kelamane S, Satyanarayana S - PLoS ONE (2011)

Contact Screening and IPT provision to childhood contacts of sputum smear positive PTB Patients, Krishna District, South India.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3142154&req=5

pone-0022500-g001: Contact Screening and IPT provision to childhood contacts of sputum smear positive PTB Patients, Krishna District, South India.
Mentions: The 825 TB patients included 628 (76%) men and 197 (24%) women. The mean age of the smear positive TB patients was 46 years (Standard deviation 15.8 years).There were a total of 172 children <6 years of age who were determined to be household contacts (Table 1). The ratio of smear positive PTB patients to child contacts below 6 years was found to be 5∶1. Of the total contacts, 116 (67.5%) contacts were screened for TB disease, none were found to have TB disease, and 97 (84%) of them were on IPT (Figure 1). Out of the 97 children who were initiated on IPT, 83 (85.5%) children were consuming Isoniazid tablets regularly as outlined under the programme.

Bottom Line: Of them, 116 (67%) were evaluated for TB disease; none were found to be TB diseased and 97 (84%) contacts were initiated on IPT and 19 (16%) contacts were not initiated on IPT due to shortage of INH tablets in peripheral health centers.Contact screening and IPT implementation under routine programmatic conditions is sub-optimal.There is an urgent need to sensitize all concerned programme staff on its importance and establishment of mechanisms for rigorous monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Medicine, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.

ABSTRACT

Background: Under India's Revised National Tuberculosis Control Programme (RNTCP), all household contacts of sputum smear positive Pulmonary Tuberculosis (PTB) patients are screened for TB. In the absence of active TB disease, household contacts aged <6 years are eligible for Isoniazid Preventive Therapy (IPT) (5 milligrams/kilogram body weight/day) for 6 months.

Objectives: To estimate the number of household contacts aged <6 years, of sputum smear positive PTB patients registered for treatment under RNTCP from April to June'2008 in Krishna District, to assess the extent to which they are screened for TB disease and in its absence initiated on IPT.

Methods: A cross sectional study was conducted. Households of all smear positive PTB cases (n = 848) registered for treatment from April to June'2008 were included. Data on the number of household contacts aged <6 years, the extent to which they were screened for TB disease, and the status of initiation of IPT, was collected.

Results: Households of 825 (97%) patients were visited, and 172 household contacts aged <6 years were identified. Of them, 116 (67%) were evaluated for TB disease; none were found to be TB diseased and 97 (84%) contacts were initiated on IPT and 19 (16%) contacts were not initiated on IPT due to shortage of INH tablets in peripheral health centers. The reasons for non-evaluation of the remaining eligible children (n = 56, 33%) include no home visit by the health staff in 25 contacts, home visit done but not evaluated in 31 contacts. House-hold contacts in rural areas were less likely to be evaluated and initiated on IPT [risk ratio 6.65 (95% CI; 3.06-14.42)].

Conclusion: Contact screening and IPT implementation under routine programmatic conditions is sub-optimal. There is an urgent need to sensitize all concerned programme staff on its importance and establishment of mechanisms for rigorous monitoring.

Show MeSH
Related in: MedlinePlus