Adherence to isoniazid preventive therapy among child contacts in Rwanda: A mixed-methods study

被引:9
作者
Birungi, Francine Mwayuma [1 ,2 ]
Graham, Stephen Michael [3 ,4 ,5 ]
Uwimana, Jeannine [1 ,6 ]
Musabimana, Angele [7 ]
van Wyk, Brian [2 ]
机构
[1] Univ Rwanda, Coll Med & Hlth Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Kigali, Rwanda
[2] Univ Western Cape, Fac Community & Hlth Sci, Bellville, South Africa
[3] Univ Melbourne, Dept Paediat, Ctr Int Child Hlth, Melbourne, Vic, Australia
[4] Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia
[5] Int Union TB & Lung Dis, Paris, France
[6] Stellenbosch Univ, Fac Med & Hlth Sci, Dept Global Hlth, Ctr Evidence Based Hlth Care,Div Epidemiol & Bios, Tygerberg, South Africa
[7] Univ Rwanda, Coll Med & Hlth Sci, Sch Publ Hlth, Kigali, Rwanda
关键词
TUBERCULOSIS TREATMENT; RISK-FACTORS; INFECTION; ADULTS; DELHI;
D O I
10.1371/journal.pone.0211934
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background The World Health Organization recommends isoniazid preventive therapy (IPT) for six months for child contacts without tuberculosis (TB), who are exposed to an adult with active TB. The effectiveness of IPT depends on 80% or greater adherence to medication. In the current study, we assessed IPT adherence and explored barriers to and facilitators of adherence among eligible child contacts in Kigali, Rwanda. Methods A mixed method study design was used to prospectively assess adherence to IPT among eligible child contacts and its associated factors through a quantitative, observational cohort study, and to explore barriers to and facilitators of adherence to IPT through a descriptive qualitative study. Results Of the 84 child contacts who started IPT, 74 (88%) had complete adherence and ten (12%) had incomplete adherence. There were no factors (individual characteristics of index cases, households and or health facility characteristics) found to be significantly associated with IPT adherence in the bivariate and multivariate analysis. In the qualitative analysis, we identified factors relating to parents/caregivers, disease, household and health-care providers as major themes determining IPT adherence. Conclusion There was a high rate of IPT completion in this cohort of eligible child contacts living in Kigali. However, structural factors (poverty and relocation) were found to be the main barriers to IPT adherence that could be addressed by health-care providers.
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页数:16
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