ontact Screening and Isoniazid Prophylaxis of Children under Age Five among Pulmonary Positive Tuberculosis Patients in Bahir Dar Special Administrative Zone, North-West Ethiopia.

Abstract

ntroduction: Tuberculosis is a Chronic necrotizing disease caused by Mycobacterium tuberculosis complex. Children are highly susceptible to tuberculosis infection and disease contacted with pulmonary positive tuberculosis patients. Up to seventy percent of children living in the same household with infectious tuberculosis patients will become infected. Thus, early contact screening and Isoniazid prophylaxis is a preventive mechanism for under five children who had contact with pulmonary positive tuberculosis patients. Objective: The objective of this study was to assess contact screening and isoniazid prophylaxis of children under age five among pulmonary positive tuberculosis patients in Bahir Dar special administrative zone, north-west Ethiopia. Methods: A facility based cross sectional study design was conducted from March 1-30/2016 in Bahir Dar special administration zone, Amhara Region. Interviewer administered questionnaire was used and 255 Pulmonary positive tuberculosis patients who had under five year children were interviewed about contact screening & Isoniazid prophylaxis for their under five children. Epi data version 3.1 was used for data entry and SPSS version 20 was used for analysis. Each independent variable was assessed for statistically significant association with the dependent variables in bivariate analysis. Those variables found less than 0.25 p-value by bivariate analysis were entered into multiple Logistic regression to identify statistically significant independent factors when the effect of other variables is adjusted. Adjusted odds ratio at 95% CI and p-value of less than 0.05 are presented. Results: - About 255 PTB+ patients were interviewed and 260 under five children were identified. Of them 149 (57.3 %) were screened for TB disease and 11 (4.2 %) were developed disease. From disease free contacts and those screened, 44 (16.9 %) were started IPT. Contact screening was associated with attitude towards contact screening (P =0.001). Contact screening was higher among females (AOR=5.3, 95% CI, (1.2, and 23.2)) and HIV positive patients were nineteen times more likely to screening adherence (AOR =19, 95 % CI: (2.1, 16.87). IPT was also associated with relationship of index cases with contacts (AOR= 0.1, 95 % CI: (0.01, 0.5)) and knowledge towards TB and IPT (P < 0.001). Conclusion: - Under five children contact screening and IPT is low in Bahir Dar special zone. Those participants who got contact screening and IPT information were only from HCWs. HCWs should increase patients’ knowledge & creating positive attitude towards under five contact screening and IPT. Health facilities should give contact screening and Isoniazid preventive therapy information of contacted under five children for every PTB+ patients and need strict follow up of them.