A STUDY OF THE STATUS AND FACTORS AFFECTING ISONIAZIDE CHEMOPROPHYLAXIS FOR PAEDIATRIC CONTACTS OF THE SMEAR POSITIVE TUBERCULOSIS CASES IN EAST DISTRICT OF SIKKIM IN INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 77
Abstract
BACKGROUND The state of Sikkim in India is overburdened with Tuberculosis (TB) in general and childhood TB in specific and is having the highest proportion of Multi Drug Resistant (MDR) TB cases in India. Isoniazide preventive therapy (IPT) has been found to be highly effective in preventing latent TB infection in children. MATERIALS AND METHODS It was a prospective study with universal sampling method conducted amongst all the children under 6 years of age who were household contacts of sputum positive pulmonary TB cases being treated in East Sikkim district in the first two quarters of 2016. Home visits were done to find out the Isoniazid prophylactic therapy status along with factors for the compliance. Eligible children not on IPT were counselled to start Isoniazid (INH) and those who initiated were counselled to complete the entire course of IPT. Home visit were made again at the end of 6 months of initiation of treatment to note their IPT completion status. RESULTS Out of the total 30 pediatric household contact, 24 (80%) initiated IPT without any health education intervention. Among those who did not initiate IPT without any health education intervention, 4 out of 5 (80%) of them initiated IPT after the health education intervention showing a positive impact of the health education given to them. Lack of awareness about IPT amongst the parents was the most common reason cited by parents for those who did not initiate IPT. After 6 months of follow up, total 20 (71.4%) children were found to have completed the IPT. Among the children who did not initially initiate IPT and then started IPT after receiving health education, 75% of them (3 out of 4) were found to have completed IPT. CONCLUSION Health education intervention was found to be an effective tool for compliance of IPT. This study had a huge impact in terms of proving that the integration of preventive therapy for the contacts along with the treatment of the index case can be done with no extra burden and cost in the ongoing National Health Programme for TB.
Authors and Affiliations
Forhad Akhtar Zaman, Vijay Kumar Mehta, Utpal Sharma
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