Barriers to Implementation of Isoniazid Preventive Treatment (IPT) in Pediatric Contacts of Sputum Positive Adults with Tuberculosis

Post Date: 
2016-03-24
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Summary: 

This study was funded by the Fogarty International Center at the U.S. National Institutes of Health. 

Young children infected with M.tuberculosis can rapidly progress to pulmonary and extrapulmonary disease with high rates of mortality and morbidity. Studies worldwide have demonstrated that IPT not only prevents latent and asymptomatic TB from progression to clinical disease, it also effectively prevents initial infection. Despite a strong body of evidence and recommendations from WHO and RNTCP, there appears to be a wide gap between the policy and practice of IPT implementation.

Under the leadership of PI Dr. Vasudha A Belgaumkar, this study funded by the Fogarty International Center will provide an approximate ratio of children eligible for IPT to sputum positive index cases. This can be useful to program managers in helping care providers be more proactive in seeking out contacts. Study findings will also aid in the planning of procurement and distribution of isoniazid to avoid shortages. Further, the study will determine if IPT is being implemented according to RNTCP guidelines.

Most importantly, we expect to identify modifiable and non-modifiable barriers and challenges to optimal implementation of IPT, which can help assess the situation in other parts of India and facilitate the initiation of corrective measures. 

Objectives:

  1. To determine whether isoniazid preventive therapy (IPT) is being provided to childhood contacts of sputum positive adults with tuberculosis according to RNTCP guidelines at Sassoon General Hospital, Pune.
  2. To document the barriers to delivery and uptake of IPT (to childhood contacts of sputum positive adults with tuberculosis) according to RNTCP guidelines at Sassoon General Hospital, Pune from provider and user perspectives.