Predictors of Isoniazid preventive Therapy uptake and completion in Under-5 contacts of Adult Tuberculosis patients in Blantyre
Abstract
Type of study: An Analytical Cross-sectional study in 14'7 high tuberculosis (TB) burden health facilities in Blantyre District.
The Problem.
The uptake oflsoniazid Preventive Therapy (IPT) among under-five children in contact with adult tuberculosis patients, has been suboptimal globally (27% versus global target of>90% annually) and Malav1,'i is no exception. Accord.ing to the United Nations High-Level Meeting, 4 million under-five children were targeted worldwide by 2022. Malawi was assigned a minimum cumulative target of 25,780 under-five children by the year 2022.
Malawi, with its high IIIVrrB burden and high child mortality, has had a few studies on factors associated with child IPT uptake. Thus, there is an urgent need to identify independent predictors oflsoniazid Preventive Therapy Uptake and Completion to reduce the national child disease burden and mortality rates.
Objectives:
To detenuine individual predictors of isoniazid uptake and completion in µnder-five children in contact with adult pulmonary TB patients in high TB burden heallh facilities in Blantyre district.
.fulecific:
1. To define the characteristics of under-five children registered for TB screening and IPT uptake and those who completed therapy.
2. To detem1ine predictors of IPT uptake and completion . Methodology:
We will do the study in fill_? out of 14 FaHdomly selected high TB burden Blantyre district facilities, Y,hieh ·,vere indepeadently seleeteEI using routinely collected medical data of the contacts registered in 2019.
Using sampling frames of facility TB contact registers, we will extract anonymized data of all4S4-registered contacts in the registers in order to get adequate sample size.ay s:,-slell'!atie raudom Saffijlling of eontaets.
Contact medical factors and demographic information will be collected. Our primary outcomes
will be the number of contacts initiated and completed IPT.
Descriptive analysis in STATA 2015, followed by logic analyses will be done(bivariable and then multivariable).
Expected Findings and Dissemination
We hypothesize that there will be a significant association between contact factors and their chances of getting TB screening, Isoniazid initiation, and completion. Thes_e findings will inform key stakeholders on strategies to improve lsoniazid uptake and the planned shorter regimen Isoniazid and Rifapentine (3HP) rollout, thereby reducing child morbidity and mortality.
Results will be disseminated through peer-reviewed publications and presentations at relevant scientific conferences and shared with key stakeholders. A project completion report will be submitted to the College of Medicine Research and Ethics Committee.
Description
Keywords
Cross sectional study in high tuberculosis burdened health facilities