Seid Getachew, Tsedalu Tsegaye, Ayele Marta
Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Wollo University, Dessie, Ethiopia.
Int J Microbiol. 2020 Sep 29;2020:8834806. doi: 10.1155/2020/8834806. eCollection 2020.
The World Health Organization recommends that all children below the age of five who have household contact with an infectious tuberculosis case should receive isoniazid preventive treatment for at least six months after the active tuberculosis disease has been ruled out. This research aims to determine the adherence of children, eligible for isoniazid preventive treatment, to the treatment who had contact with pulmonary tuberculosis patients.
A mixed study design was used to prospectively assess the adherence to IPT among children under the age of 5 in contact with pulmonary TB patients through the quantitative study design and barriers of adherence in view of health care professionals and the family of children through a descriptive qualitative study. The study was conducted from July 2019 to December 2019 in Addis Ababa. Data were collected by a structured datasheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants.
The ratio of the total number of pulmonary tuberculosis index cases recruited into the study to the number of child contacts aged less than 5 years was 1 : 1.32. The total isoniazid preventive treatment uptake in this study was 75.2%; one-fifth (21.3%) of the children who started IPT did not complete the full course of six-month isoniazid preventive treatment. Except for HIV not to be tested ( < 0.001), there was no significant association of the listed risk factors in default to complete the full six months of preventive treatment.
Enrolment of eligible children for isoniazid preventive treatment in the urban city Addis Ababa was still below the target of the World Health Organization End tuberculosis strategy by 2030. The treatment adherence rate also needs a great deal of effort to achieve the strategy. Child default after the first visit indicates a lack of understanding about the benefit and safety of preventive therapy in young children among families of TB patients, and awareness-creating efforts by health extension workers will help to improve the outcomes.
世界卫生组织建议，所有与传染性结核病病例有家庭接触的五岁以下儿童，在排除活动性结核病后应接受至少六个月的异烟肼预防性治疗。本研究旨在确定有资格接受异烟肼预防性治疗的儿童对与肺结核患者接触后的治疗的依从性。
采用混合研究设计，通过定量研究设计前瞻性评估5岁以下与肺结核患者接触儿童对IPT的依从性，并通过描述性定性研究，从医护人员和儿童家庭的角度评估依从性障碍。该研究于2019年7月至2019年12月在亚的斯亚贝巴进行。通过结构化数据表从选定的健康中心登记册收集数据。数据录入Epi Data软件，并使用SPSS 20版进行分析。采用描述性统计方法总结研究参与者的社会人口学特征。
纳入研究的肺结核指数病例总数与5岁以下儿童接触者数量之比为1∶1.32。本研究中异烟肼预防性治疗的总接受率为75.2%；开始接受IPT治疗的儿童中有五分之一（21.3%）未完成为期六个月的异烟肼预防性治疗的全部疗程。除未检测HIV（<0.001）外，所列风险因素与未完成全部六个月预防性治疗之间无显著关联。
在亚的斯亚贝巴市，符合条件的儿童接受异烟肼预防性治疗的登记率仍低于世界卫生组织《203结核病防治战略》的目标。治疗依从率也需要付出巨大努力才能实现该战略。首次就诊后儿童的违约表明，结核病患者家庭对幼儿预防性治疗的益处和安全性缺乏了解，健康推广工作者开展的提高认识工作将有助于改善治疗效果。
