THE HAGUE, Netherlands – Children – especially very young children – are at high risk of developing severe tuberculosis illness when exposed to a member of their household who has active disease, but only 23 percent of child contacts of adults with active disease are provided with TB preventive therapy, researchers said here. That leaves 1.3 million children under the age of five who are eligible for isoniazid preventive therapy without access to the intervention that would prevent illness, according to the World Health Organization. Preliminary results from a study released here show how that can change.
The study enrolled 2,000 infected child contacts of adults with active TB in Benin, Burkina Faso, Cameroon and the Central African Republic, and provided the 90 percent of enrollees eligible for preventive therapy with a 3-month regimen of rifampicin and isoniazid – half the time of a standard 6-month preventive therapy regimen which includes just isoniazid. Ninety-two percent of participants completed the course of preventive therapy, with no adverse events reported. Five percent of children screened were found to have active disease and were placed them on treatment.
These results show that preventing TB in children with a short-course regimen is feasible and well tolerated, Valerie Schwoebel with The Union – which conducted the study – said.
“Full implementation of household contact investigation would prevent thousands of child deaths,” she said.
Scaling up contact tracing is one of the goals outlined in the UN High Level Meeting’s political declaration to eliminate TB, which calls for preventing infection in 30 million people, including 4 million children under the age of five by 2022.
“Studies like this can make a huge difference to the response rate and provide a vital way to ensure the rights of every child are respected,” Jose Luis Castro, executive director of The Union said.
“Children with TB have been widely neglected by health systems, but the human rights-based TB agenda established at the recent UN High Level Meeting on TB sends a clear signal that such scandalous practices will no longer be tolerated at any level of the response,” he said.