Correlates of Isoniazid Preventive Therapy Failure in Child Household Contacts with Infectious Tuberculosis in High Burden Settings in Nairobi, Kenya – a Cohort Study

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dc.contributor.authorOkwara, Florence Nafula
dc.contributor.authorOyore, John Paul
dc.contributor.authorWere, Fred Nabwire
dc.contributor.authorGwer, Samson
dc.date.accessioned2023-05-16T13:12:02Z
dc.date.available2023-05-16T13:12:02Z
dc.date.issued2017
dc.descriptionArticleen_US
dc.description.abstractBackground: Sub-Saharan Africa continues to document high pediatric tuberculosis (TB) burden, especially among the urban poor. One recommended preventive strategy involves tracking and isoniazid preventive therapy (IPT) for children under 5 years in close contact with infectious TB. However, sub-optimal effectiveness has been documented in diverse settings. We conducted a study to elucidate correlates to IPT strategy failure in children below 5 years in high burden settings. Methods: A prospective longitudinal cohort study was done in informal settlings in Nairobi, where children under 5 years in household contact with recently diagnosed smear positive TB adults were enrolled. Consent was sought. Structured questionnaires administered sought information on index case treatment, socio-demographics and TB knowledge. Contacts underwent baseline clinical screening exclude TB and/or pre-existing chronic conditions. Contacts were then put on daily isoniazid for 6 months and monitored for new TB disease, compliance and side effects. Follow-up continued for another 6 months. Results: At baseline, 428 contacts were screened, and 14(3.2%) had evidence of TB disease, hence excluded. Of 414 contacts put on IPT, 368 (88.8%) completed the 1 year follow-up. Operational challenges were reported by 258(70%) households, while 82(22%) reported side effects. Good compliance was documented in 89% (CI:80.2–96.2). By endpoint, 6(1.6%) contacts developed evidence of new TB disease and required definitive anti-tuberculosis therapy. The main factor associated with IPT failure was under-nutrition of contacts (p = 0.023). Conclusion: Under-nutrition was associated with IPT failure for child contacts below 5 years in high burden, resource limited settings. IPT effectiveness could be optimized through nutrition support of contacts.en_US
dc.description.sponsorshipKenya National Council of Science Technology and Innovation (NACOSTI) and Kenyatta University, Nairobi.en_US
dc.identifier.citationOkwara, F. N., Oyore, J. P., Were, F. N., & Gwer, S. (2017). Correlates of isoniazid preventive therapy failure in child household contacts with infectious tuberculosis in high burden settings in Nairobi, Kenya–a cohort study. BMC infectious diseases, 17(1), 1-11.en_US
dc.identifier.otherDOI 10.1186/s12879-017-2719-8
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/25316
dc.language.isoenen_US
dc.publisherBMC Infectious Diseasesen_US
dc.subjectTuberculosisen_US
dc.subjectChildrenen_US
dc.subjectIsoniaziden_US
dc.subjectPreventionen_US
dc.subjectFailureen_US
dc.titleCorrelates of Isoniazid Preventive Therapy Failure in Child Household Contacts with Infectious Tuberculosis in High Burden Settings in Nairobi, Kenya – a Cohort Studyen_US
dc.typeArticleen_US
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