Management of children exposed to<i>Mycobacterium tuberculosis</i>: a public health evaluation in West Java, Indonesia

Rutherford, Merrin; Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; Crevel, Reinout van; Hill, Philip C.

doi:10.2471/blt.13.118414

Cited by 49 publications

(46 citation statements)

References 26 publications

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“…In realising the secondary aim of this study to determine the number of children screened and provided with IPT, our limited experience shows that a low percentage of children (26%) attended screening after verbal and written advice, although this is higher than that reported in some cohorts in Sub Saharan Africa , India and Indonesia . The high attrition rate of children who are referred for further tests or antibiotics following initial IPT screening (16%) is concerning, particularly as a proportion of these children requiring further investigation may have active TB.…”

Section: Discussionmentioning

confidence: 95%

Challenges to delivery of isoniazid preventive therapy in a cohort of children exposed to tuberculosis in Timor‐Leste

Hall

Sukijthamapan

Santos

et al. 2015

Tropical Med Int Health

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Abstractobjectives To evaluate the number and geographic location of children aged <5 years exposed to sputum smear-positive tuberculosis (TB) in Timor-Leste, to determine the proportion evaluated for isoniazid preventive therapy (IPT) and to review the programmatic challenges present in delivering IPT to this cohort.methods A total of 256 consecutive sputum smear-positive TB index cases diagnosed at Bairo Pite Clinic between August 2013 and July 2014 were interviewed about places of residence and household contacts <5 years of age in the 3 months preceding diagnosis. Attendance of these contacts for screening and the outcome of screening were recorded prospectively.results The majority (225 of 256, 88%) of index cases resided in Dili, but 73 of 225 (32%) of these also had a second address outside the capital. A total of 255 contacts were identified; 172 of 255 (67%) of whom lived in Dili district and 83 of 255 (33%) of whom resided in remote districts. Only 66 of 255 (26%) contacts attended for evaluation for IPT, of whom 46 of 255 (18%) started IPT and nine of 255 (3.5%) were diagnosed with TB. Attendance was significantly less likely when the index case was not the parent of the child contact.conclusions Sputum smear-positive pulmonary TB cases frequently result in household exposure of children <5 years in Timor-Leste, and provision of IPT is suboptimal. Contacts are located in diverse and distant locations. Further studies to delineate access barriers to IPT and review programmatic models that will facilitate IPT scale up in Timor-Leste are needed.

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Section: Discussionmentioning

confidence: 95%

Challenges to delivery of isoniazid preventive therapy in a cohort of children exposed to tuberculosis in Timor‐Leste

Hall

Sukijthamapan

Santos

et al. 2015

Tropical Med Int Health

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“…While financial cost was an issue for some, the duration of travel from people's homes to the nearest clinic appeared to be the principal issue for many . Seasonal farming demands and other family priorities, particularly for mothers, were often recognised as more important than taking children to the clinic . To compound this, many clinics often reported significant waiting times, up to 4 h, and irregular scheduling of clinics, which further discouraged families from committing to the treatment process.…”

Section: Discussionmentioning

confidence: 96%

“…To compound this, many clinics often reported significant waiting times, up to 4 h, and irregular scheduling of clinics, which further discouraged families from committing to the treatment process. The cost of treatment itself did not appear to present as significant an issue as travel overall; however, this was also mentioned as an obstacle in some areas . Many study participants and authors indicated that enhanced access to IPT through provision at peripheral health sites in rural areas could greatly contribute to improved uptake for children in these regions who may otherwise miss out on treatment .…”

Section: Discussionmentioning

confidence: 98%

“…A recurring theme throughout the different studies was the burden of travel for caregivers of children that had been advised to complete IPT. While financial cost was an issue for some, the duration of travel from people's homes to the nearest clinic appeared to be the principal issue for many . Seasonal farming demands and other family priorities, particularly for mothers, were often recognised as more important than taking children to the clinic .…”

Section: Discussionmentioning

confidence: 99%

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Barriers to the implementation of isoniazid preventive therapy for tuberculosis in children in endemic settings: A review

Grace

2019

J Paediatrics Child Health

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Isoniazid preventive therapy is one of the key interventions in reducing the risk of active disease among children exposed to tuberculosis. However, initiation and maintenance of this treatment is poor in many areas. This review summarises the existing literature on barriers to implementation of isoniazid preventive therapy for tuberculosis in children in endemic settings. MEDLINE, EMBASE and CINAHL databases were used to search for primary research studies published between 1998 and 2018, specifically mentioning isoniazid preventive therapy, tuberculosis and children. Barriers identified in most study settings included absence of parental risk perception, health‐care worker knowledge gaps and treatment access. Focusing on patient‐centred care, enhancing community and health‐care worker education and securing stable medication supply to effectively deliver this therapy is crucial in order to reduce childhood morbidity and mortality from tuberculosis.

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“…Another recent study from Indonesia quantified the large existing gaps at each stage of the evaluation and management process. 19 Since 2011, the NTP of Viet Nam with the technical support of KNCV has implemented community-based contact screening and management in four provinces in Viet Nam, with the ultimate aim of stepwise implementation to all provinces by 2020.…”

Section: Examples Of Recent National Initiatives For Implementationmentioning

confidence: 99%

Regional initiatives to address the challenges of tuberculosis in children: perspectives from the Asia-Pacific region

Graham

Grzemska

Brands

et al. 2015

International Journal of Infectious Diseases

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Increasing attention is being given to the challenges of management and prevention of tuberculosis in children and adolescents. There have been a number of recent important milestones achieved at the global level to address this previously neglected disease. There is now a need to increase activities and build partnerships at the regional and national levels in order to address the wide policy-practice gaps for implementation, and to take the key steps outlined in the Roadmap for Child Tuberculosis published in 2013. In this article, we provide the rationale and suggest strategies illustrated with examples to improve diagnosis, management, outcomes and prevention for children with tuberculosis in the Asia-Pacific region, with an emphasis on the need for greatly improved recording and reporting. Effective collaboration with community engagement between the child health sector, the National Tuberculosis control Programmes, community-based services and the communities themselves are essential.

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Management of children exposed toMycobacterium tuberculosis: a public health evaluation in West Java, Indonesia

Cited by 49 publications

References 26 publications

Challenges to delivery of isoniazid preventive therapy in a cohort of children exposed to tuberculosis in Timor‐Leste

Challenges to delivery of isoniazid preventive therapy in a cohort of children exposed to tuberculosis in Timor‐Leste

Barriers to the implementation of isoniazid preventive therapy for tuberculosis in children in endemic settings: A review

Regional initiatives to address the challenges of tuberculosis in children: perspectives from the Asia-Pacific region

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