Predictors of Isoniazid preventive Therapy uptake and completion in under-5 contacts of adult tuberculosis patients in Blantyre
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Date
2021-08-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Type of study: An Analytical Cross-sectional study in 7 high tuberculosis (TB) burden health
facilities in Blanryre District.
ihe Problem.
The uptake oflsoniazid Prev,:ntive Therapy (IPT) among under-hve childran in contact with
adult tuberculosis patients, has heen suboptimal globally (Z1Y"versus global target of>90%"
annually) and Malawi is no excr:ption. According to the United Nations High-Levei Meeting, 4
million under-five children wer,) targeted worldwide by 2022. Malawi was assigned a
minimumcumulativetargetof1:5,780under-fivechildrenbytheyear2022"
Malawi, with its high HIV/TB bun,en and high child mortality, has had a few studies on
factors associated with child IP',] uptake. Thus, there is an urgent need to identil), independent
predictors oflsoniazid Preventive Therapy Uptake and Completion to reduce the national child
disease burden and mortality rates.
Objectives:
To determine individual predictors ofisoniazid uptake and completion in under-five children
in contact with adult pulmonary TB patients in high TB burden health facilities in Blantyre
district.
Specific:
l. To define the characteristics ofunder-fi.Ie children registered for TB screening and
IPT uptake and those who completed therapy.
2. To determine predictors of IPT uptake md completion u*i@
tegi$ti€+egressiee
Methodoloe-v:
We will do the study in 7 out of 14 randomly sel,:cted high TB burden Blantyre district facilities,
iadcpende"tly-sl€et€C, +*ieh-*ee;neepeAfuwhich were independently selected seleeted
usin
3 routinely collected medical data ofthe contacts registered in 2019.
Using sampling frames of facility TB contact registers, we will extract anonymized data of 484
contacts by systematic random sampling ofcontacts.
Contact medical factors ard demographic information will be collected. Our primary outcr nes
will be the number of conlacts initiated and conlrleted IPT.
Descriptive analysis in S1'ATA 2015, followed ,ry logic analyses will be done(bivariable and
then multivariable).
Exper@
We h1 cothesize that there will be a significant association between contact factors and their
chance, cfgetting TB screening, Isoniazid initiation, and completion. These findings will inform
key stakeholders on strategies to improve Isoniazid uptake and the planned shorter regimen
Isoniazid and Rifapentine (3HP) rollou! thereby reducing child morbidity and mortaliiy.
Results .,vi11 be disseminated through peer-reviewed publications and presentations ar relevant
scientifi,; conferences and shared with key stakeholders. A project completion report will be
submitted to the College of Medicine Research and Ethics Committee.