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Open Access Caregiver willingness to give TPT to children living with drug-resistant TB patients

BACKGROUND Pediatric household contacts (HHCs) of patients with multidrug-resistant TB (MDR-TB) are at high risk of infection and active disease. Evidence of caregiver willingness to give MDR-TB preventive therapy (TPT) to children is limited.

METHODS This was a cross-sectional study of HHCs of patients with MDR-TB to assess caregiver willingness to give TPT to children aged <13 years.

RESULTS Of 743 adult and adolescent HHCs, 299 reported caring for children aged <13 years of age. The median caregiver age was 35 years (IQR 27–48); 75% were women. Among caregivers, 89% were willing to give children MDR TPT. In unadjusted analyses, increased willingness was associated with TB-related knowledge (OR 5.1, 95% CI 2.3–11.3), belief that one can die of MDR-TB (OR 5.2, 95% CI 1.2–23.4), concern for MDR-TB transmission to child (OR 4.5, 95% CI 1.6–12.4), confidence in properly taking TPT (OR 4.5, 95% CI 1.6–12.6), comfort telling family about TPT (OR 5.5, 95% CI 2.1–14.3), and willingness to take TPT oneself (OR 35.1, 95% CI 11.0–112.8).

CONCLUSIONS A high percentage of caregivers living with MDR- or rifampicin-resistant TB patients were willing to give children a hypothetical MDR TPT. These results provide important evidence for the potential uptake of effective MDR TPT when implemented.

Keywords: children; contacts; pediatric; prophylaxis; tuberculosis

Document Type: Research Article

Affiliations: 1: GHESKIO Centers, Port-au-Prince, Haiti and Weill Cornell Medicine, Center for Global Health, Department of Medicine, New York, NY 2: Johns Hopkins Medical Institutions, Baltimore, MD 3: Frontier Science Foundation, Brookline, MA 4: Social and Scientific Systems, Inc., Silver Springs, MD, USA 5: South African Tuberculosis Vaccine Initiative (SATVI), Cape Town, South Africa 6: University of Cape Town Lung Institute, Mowbray, South Africa 7: Gaborone Clinical Research Site, Gaborone, Botswana 8: TASK Applied Science Clinical Research Site, Bellville, South Africa 9: Asociación Civil Impacta Salud y Educación – Barranco Clinical Research Site, Lima, Peru 10: Sizwe Tropical Disease Hospital, Johannesburg, South Africa 11: Byramjee Jeejeebhoy Government Medical College Clinical Trials Unit, Pune, India 12: Harvard T H Chan School of Public Health, Boston, MA 13: Emory University Rollins School of Public Health, Atlanta, GA, USA 14: School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Aurum Institute, Johannesburg, South Africa 15: University of Nebraska Medical Center, Omaha, NE, USA 16: Desmond Tutu TB Centre, Stellenbosch University, Tygerberg, South Africa

Publication date: October 1, 2022

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