Closing the loop in child TB contact management: completion of TB preventive therapy outcomes in western Kenya
Amisi, James A. ; Carter, E. Jane ; Masini, Enos ; Szkwarko, Daria
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Abstract
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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Amisi JA, Carter EJ, Masini E, Szkwarko D. Closing the loop in child TB contact management: completion of TB preventive therapy outcomes in western Kenya. BMJ Open. 2021 Feb 23;11(2):e040993. doi: 10.1136/bmjopen-2020-040993. PMID: 33622944; PMCID: PMC7907885. Link to article on publisher's site