Twice-weekly therapy for children with tuberculosis infection or exposure
OBJECTIVE: To determine the safety, adherence and efficacy of intermittent directly observed preventive therapy (DOPT).
DESIGN: Retrospective cohort of children receiving intermittent DOPT for exposure to tuberculosis (TB) or latent TB infection (LTBI) seen from 1989 to 2011 at one clinic.
RESULTS: A total of 1383 children were treated for either TB exposure for 2–3 months (n = 935, 68%) or LTBI for 9 months (n = 448, 32%) with isoniazid 20–30 mg/kg/dose or rifampin 10–15 mg/kg/dose biweekly. All children with exposure and 411 (92%) with LTBI were identified via contact investigations. Twelve (1.3%) children with exposure experienced adverse effects (5 abdominal pain, 4 vomiting, 3 rash); 8 had transaminases evaluated and only 1 had elevated levels. Thirty (6.7%) children with LTBI experienced adverse effects (16 abdominal pain, 6 rash, 3 vomiting, 3 headache and 2 abdominal pain/vomiting); 19 had transaminases obtained and 2 had elevated transaminases. All transaminases normalized after the discontinuation of medication. Over 99% of exposed and 95.8% of infected children completed treatment. One child, who had sickle cell anemia, was treated for LTBI and later developed TB disease. When compared to rates of disease progression by age, the efficacy of intermittent DOPT was 98%.
CONCLUSION: Intermittent DOPT in childhood TB is safe, effective and offers high adherence rates.
Document Type: Research Article
Affiliations: Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
Publication date: February 1, 2013
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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