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Contact screening and chemoprophylaxis in India's Revised Tuberculosis Control Programme: a situational analysis

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BACKGROUND: India's Revised National Tuberculosis Control Programme (RNTCP) recommends screening of all household contacts of smear-positive pulmonary tuberculosis (PTB) cases for tuberculosis (TB) disease, and 6-month isoniazid preventive therapy (IPT) for asymptomatic children aged <6 years.

OBJECTIVE: To assess the implementation of child contact screening and IPT administration under the RNTCP.

METHODS: A cross-sectional study conducted in four randomly selected TB units (TUs), two in an urban (Chennai City) and two in a rural (Vellore District) area of Tamil Nadu, South India, from July to September 2008. The study involved the perusal of TB treatment cards of source cases (new or retreatment smear-positive PTB patients started on treatment), interview of source cases and focus group discussions (FGDs) among health care workers.

RESULTS: Interviews of 253 PTB patients revealed that of 220 contacts aged <14 years, only 31 (14%) had been screened for TB, and that of 84 household children aged <6 years, only 16 (19%) had been initiated on IPT. The treatment cards of source cases lacked documentation of contact details. FGDs revealed greater TB awareness among urban health care workers, but a lack of detailed knowledge about procedures.

CONCLUSION: Provision for documentation using a separate IPT card and focused training may help improve the implementation of contact screening and IPT.

Keywords: IPT; RNTCP; chemoprophylaxis; children; contact screening

Document Type: Regular Paper

Affiliations: 1: Tuberculosis Research Centre, Chennai, India 2: Office of the World Health Organization Representative to India, New Delhi, India

Publication date: December 1, 2009

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