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Open Access Routine programmatic delivery of isoniazid preventive therapy to children in Cape Town, South Africa

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SETTING: Fourteen primary health care facilities in Cape Town, South Africa.

OBJECTIVE: To determine the proportion and characteristics of infectious adult tuberculosis (TB) cases that identify children aged <5 years who qualify for isoniazid preventive therapy (IPT), and to determine the proportion of children who initiate and complete IPT.

DESIGN: A retrospective clinical record review conducted as a stratified cluster survey.

RESULTS: Of 1179 records of infectious adult cases, 33.3% had no documentation of contacts. Of the remaining 786 records, 525 contacts aged <5 years were identified, representing 0.7 child contacts per infectious adult case. Older age, male, human immunodeficiency virus (HIV) positive, smear-negative and retreatment TB cases were all associated with no documentation of contacts. Of the 525 child contacts identified, less than half were screened for TB, 141 initiated IPT and 19 completed it.

CONCLUSION: Less than 67% of infectious TB case records had documentation of contacts. Younger, female, HIV-negative and new smear-positive TB cases were more likely to have had contacts identified. Less than 14% of children already initiated on IPT completed 6 months of treatment.
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Keywords: IPT; child contacts; completion; index case

Document Type: Research Article

Affiliations: 1: City Health Directorate, City of Cape Town, Cape Town, South Africa 2: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa 3: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa; and International Union Against Tuberculosis and Lung Disease, Paris, France 4: International Union Against Tuberculosis and Lung Disease, Paris, France 5: The Medical Research Council of South Africa, Biostatistical Unit, Cape Town, South Africa

Publication date: September 21, 2013

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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