High Isoniazid Preventive Therapy Completion Rate among Household Contacts of Tuberculosis Patients in Duhok Province

Main Article Content

Fatima Nawaf Abdulkareem
Muayad Aghali Merza
Ahmed Mohammed Salih
Abdulrahman Islam Rekani

Keywords

Tuberculosis, LTBI, Isoniazid, household contacts

Abstract

Background And Objective: Tuberculosis (TB) preventive therapy is a key intervention to achieve a world free of TB. We assessed the completion rate of isoniazid preventive therapy (IPT) among household contacts (HHCs) in Duhok province.
Methods: A cross-sectional study was conducted from April to September 2021 at the National TB Program Center (NTP). HHCs who were positive for the Tuberculin Skin Test (TST) and/or the Quantiferon TB-Gold Plus Assay (QFTPlus) with active TB cases were included in the study. A standard questionnaire was adopted for sociodemographic and clinical characteristics. The HHCs receiving INH therapy were advised to continue the treatment for 6 months under regular monthly follow-up.
Results: Of a total of 181, 134 (74.04%) were accepted and completed the treatment, whereas 47 (25.96%) declined IP. 41 (22.7%) of the LTBI-positive HHCs were among the 25–34 age group. The IPT completion rate in males (58.2%) was slightly higher when compared to females (42.4%) without a significant difference of p value 0.92 (OR 0.96, 95% CI 0.49–1.89). No differences were noticed among smokers, alcoholics, diabetics, or those on immunosuppressive treatment.
Conclusion: There was a high rate of LTBI completion with an excellent drug safety profile among the HHCs in Duhok province. Therefore, it is an essential component of the TB program to offer chemoprophylaxis to LTBI HHCs with regular follow-ups. Furthermore, there were no significant associations between age group, gender, smoking, alcohol consumption, DM, and immunosuppressive therapy, with the completion rate of IPT.

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References

1. World Health Organization, Global tuberculosis report 2021. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO. 2020.
2. LoBue, P., D. Enarson, and T. Thoen, Tuberculosis in humans and its epidemiology, diagnosis and treatment in the United States[Serialised article. Tuberculosis: a re-emerging disease in animals and humans. Number 2 in the series]. The International journal of tuberculosis and lung disease, 2010. 14(10): p. 1226-1232.
3. World Health Organization, WHO consolidated guidelines on tuberculosis: module 1: prevention: infection prevention and control. 2022.
4. Ai, J.-W., et al., Updates on the risk factors for latent tuberculosis reactivation and their managements. Emerging microbes & infections, 2016. 5(1): p. 1-8.
5. Association, N.T.C., C.f.D. Control, and Prevention, Guidelines for the investigation of contacts of persons with infectious tuberculosis. Recommendations from the National Tuberculosis Controllers Association and CDC. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 2005. 54(RR-15): p. 1-47.
6. Kabbara, W.K., A.T. Sarkis, and P.G. Saroufim, Acute and fatal isoniazid-induced hepatotoxicity: a case report and review of the literature. Case reports in infectious diseases, 2016. 2016.
7. Sterling, T.R., et al., Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC, 2020. 2020, Wiley Online Library. p. 1196-1206.
8. Abdulkareem, F.N., M.A. Merza, and A.M. Salih, First insight into latent tuberculosis infection among household contacts of tuberculosis patients in Duhok, Iraqi Kurdistan: using tuberculin skin test and QuantiFERON-TB Gold Plus test. International Journal of Infectious Diseases, 2020. 96: p. 97-104.
9. Organization, W.H., Guidelines on the management of latent tuberculosis infection. 2015: World Health Organization.
10. Almufty, H.B., I.S. Abdulrahman, and M.A. Merza, Latent tuberculosis infection among healthcare workers in Duhok Province: from screening to prophylactic treatment. Tropical medicine and infectious disease, 2019. 4(2): p. 85.
11. Arguello Perez, E., et al., Management of latent tuberculosis infection among healthcare workers: 10-year experience at a single center. Clinical Infectious Diseases, 2017. 65(12): p. 2105-2111.
12. Joseph, H.A., et al., Factors influencing health care workers' adherence to work site tuberculosis screening and treatment policies. American journal of infection control, 2004. 32(8): p. 456-461.
13. Türkkani, M.H., et al., The Treatment of Latent Tuberculosis Infection: Province Based Practice and Problems. Türkiye Klinikleri. Tip Bilimleri Dergisi, 2020. 40(3): p. 358-365.
14. Machado, A., Jr., et al., Risk factors for failure to complete a course of latent tuberculosis infection treatment in Salvador, Brazil. Int J Tuberc Lung Dis, 2009. 13(6): p. 719-25.
15. Chee, C., et al., Treatment of latent TB infection for close contacts as a complementary TB control strategy in Singapore. The International Journal of Tuberculosis and Lung Disease, 2004. 8(2): p. 226-231.
16. Olsson, O., et al., High rate of latent tuberculosis treatment completion in immigrants seeking asylum in Sweden. Infectious Diseases, 2018. 50(9): p. 678-686.
17. Lavigne, M., et al., The impact of smoking on adherence to treatment for latent tuberculosis infection. BMC Public Health, 2006. 6(1): p. 1-4.
18. Den Boon, S., et al., Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area. Thorax, 2005. 60(7): p. 555-557.
19. Lienhardt, C., et al., Investigation of the risk factors for tuberculosis: a case–control study in three countries in West Africa. International journal of epidemiology, 2005. 34(4): p. 914-923.
20. Gajalakshmi, V., et al., Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43 000 adult male deaths and 35 000 controls. The Lancet, 2003. 362(9383): p. 507-515.
21. Merza, M.A., A 5-year experience characterizing the demographic and clinical profile and directly observed treatment short-course treatment outcome in National Tuberculosis Center of Duhok province, Iraqi Kurdistan. SAGE Open Medicine, 2020. 8: p. 2050312120921055.