Factors associated with uptake of isoniazid preventive therapy among children under 5 years tuberculosis contacts in greater Kibaale, Uganda

Abstract

Isoniazid Preventive Therapy (IPT) is a chemoprophylaxis which reduces the risk of the first episode of TB occurring in people exposed to an infection or with latent infection and the risk of a recurrent episode of TB. 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 children contacts of smear-positive TB index cases are on preventive treatment. The objective of this study was to assess factors associated with uptake of isoniazid preventive therapy among children under 5 years’ tuberculosis contacts in Greater Kibaale. An analytical cross-sectional study design utilizing both quantitative and qualitative methods was conducted among 207 children under 5 years’ tuberculosis contacts. They were recruited using convenience sampling methods. The caregiver of the children completed a structured questionnaire in English and translated into Lunyoro. Data was single-entered and analyzed using SPSS version 22. Bivariate, univariate and multivariate Logistic regression analysis methods were used to identify factors associated with uptake of isoniazid preventive. Of 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. Conclusively, the level of uptake of IPT was low. Contact screening seems a good entry point for delivery of Isoniazid Preventive Therapy to at-risk children when routinely practised as recommended by WHO.