Abelti Eshetu, Dememew Zewdu, Gebreyohannes Asfawesen, Alemayehu Yohannes, Terfassa Tilay, Janfa Taye, Jerene Degu, Suarez Pedro, Datiko Daniel
USAID (United States Agency for International Development) Eliminate TB Project, KNCV (The Royal Netherlands Tuberculosis Association) Tuberculosis Foundation, Addis Ababa P.O. Box 1110, Ethiopia.
USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa P.O. Box 1157, Ethiopia.
Trop Med Infect Dis. 2025 Apr 9;10(4):102. doi: 10.3390/tropicalmed10040102.
There are limited studies on the community-based outcomes of tuberculosis (TB) preventive treatment (TPT) among children and adolescent contacts <15 years in Ethiopia. Our objective was to assess TPT uptake and completion rates among eligible under-15-year-old TB household contacts through an enhanced community-based model of interventions. The study was conducted between July 2021 and June 2022 in twenty primary health care units in the Sidama and Southern Nations, Nationalities, and Peoples' Region (SNNPR) regions. A total of 4367 (99.2%) household contacts of 1069 bacteriologically confirmed PTB index cases were symptomatically screened for TB by trained health extension workers (HEWs) at the community level. A total of 696 (15.9%) symptomatic contacts were identified, of which 694 (99.7%) were evaluated for TB, resulting in 60 (8.6%) TB cases. A total of 1567 (95.3%) asymptomatic children and adolescent contacts <15 years of age were initiated on TPT (88.8%) at health posts in the community. After the interventions, there was a significant increase in contact screening coverage (95.6% vs. 99.2%, Odds Ratio (OR), 5.54; 95% Confidence interval (CI), 2.93-10.13) and TPT uptake (81.7% vs. 95.4%; OR, 4.67; 95% CI, 2.54-8.23). The TPT completion rate was also 98.1% (of 1567). The TPT completion rate at health posts in the community was higher than the rate at health centers (99.4% vs. 88.0%; OR, 20.95; 95% CI, 8.97-52.71). TPT uptake and completion in children and adolescent contacts could be improved remarkably with the implementation of an enhanced community-based model of intervention in high-TB-burden districts.
在埃塞俄比亚，针对15岁以下儿童和青少年结核病（TB）接触者开展基于社区的预防性治疗（TPT）效果的研究有限。我们的目标是通过强化基于社区的干预模式，评估符合条件的15岁以下结核病家庭接触者的TPT接受率和完成率。该研究于2021年7月至2022年6月在锡达马以及南方各族州（SNNPR）地区的20个初级卫生保健单位开展。共有1069例经细菌学确诊的肺结核指数病例的4367名（99.2%）家庭接触者，由经过培训的社区卫生推广工作者（HEW）在社区层面进行了结核病症状筛查。共识别出696名（15.9%）有症状的接触者，其中694名（99.7%）接受了结核病评估，确诊60例（8.6%）结核病病例。共有1567名（95.3%）15岁以下无症状儿童和青少年接触者在社区卫生站开始接受TPT（88.8%）。干预措施实施后，接触者筛查覆盖率显著提高（95.6%对99.2%，优势比（OR）为5.54；95%置信区间（CI）为2.93 - 10.13），TPT接受率也显著提高（81.7%对95.4%；OR为4.67；95% CI为2.54 - 8.23）。TPT完成率为98.1%（1567名中的）。社区卫生站的TPT完成率高于卫生中心（99.4%对88.0%；OR为20.95；95% CI为8.97 - 52.71）。在结核病高负担地区实施强化的基于社区的干预模式，可以显著提高儿童和青少年接触者的TPT接受率和完成率。
