Factors associated with uptake of isoniazid preventive therapy among children under 5 years tuberculosis contacts; case study: Greater Kibaale

Abstract

Introduction: Isoniazid Preventive Therapy (IPT) is a chemoprophylaxis which reduces the risk of a first episode of TB occurring in people exposed to infection or with latent infection and the risk a recurrent episode of TB (WHO, 2018). WHO recommends isoniazid taken at a daily dose of 5 mg/kg (maximum 300 mg) for at least six months. In Uganda, only 16% of 15957 child contacts of smear positive TB index cases are on preventive treatment. Relatedly Hoima region in which greater Kibaale falls it was reported that 2608 under 15 contacts were listed and evaluated of which only 29 (1.113%) were initiated on IPT still below WHO recommendation. Objective: The objective of the current study was to assess factors associated with uptake of isoniazid preventive therapy among children under 5 years’ tuberculosis contacts in Greater Kibaale. Methodology: A cross-sectional study design utilizing both quantitative and qualitative method which was conducted among 207 children under 5 years’ tuberculosis contacts who were recruited using purposive sampling methods. The caregiver of the children completed a structured questionnaire which was in English and translated in Runyoro. Data was collected by administering pretested structured questionnaires by trained research Assistants, KII guide was to collect qualitative data. Data was single -entered and analyzed using statistical software version 22 for analysis. Frequency tables and graphs were used to describe the study variables. Bivariate, univariate and multivariate Logistic regression analysis methods were used to identify factors associated with uptake of isoniazid preventive. Variables with P-value of <0.05 with 95% CI were used to declare statistical significance. Results: From the 207 participants, the uptake IPT was low at 36.7%. Being in the age group of 35-44 years (AOR=15.856, 95% CI: 11.568-27.115), being married, AOR=17.867, 95% CI: 4.631-215.769), p=.008) being separated (AOR=4.4.35, 95% CI; 1.056-6.530, p=0.047), having a monthly income of 40,000-100,000 shillings (AOR=9.917, 95% CI: 6.380-15.450, p=.000), finding it easy to talk to other people about TB problem AOR=.012, 95% CI: .004-.303, p=.007), not screening for TB (AOR=0.391, 95% CI: .242-.791, p=.000) and receiving continuous counselling (AOR=0.004, 95% CI: .001-.142, p=.002) were independently associated with uptake of isoniazid preventive. Conclusions: The study revealed that the level of uptake of IPT was low at 36.7% and being aged 34-44 years, being married, being separated, having a monthly income of 40,000-100,000 shillings, finding it easy to talk to other people about TB problem, not screening for TB and receiving continuous counselling were influencer of uptake of isoniazid preventive therapy. Therefore the study recommends that Contact screening is a good entry point for delivery of Isoniazid Preventive Therapy to at risk children and should be routine practice as recommended by the WHO despite the implementation challenges.