Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya
BACKGROUND: The study assessed whether a “7-1-7” timeliness metric for screening and TB preventive therapy (TPT) could be implemented for household contacts (HHCs) of index patients with bacteriologically confirmed pulmonary TB under routine programmatic settings in Kenya. METHODS: A longitudinal co...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
International Union Against Tuberculosis and Lung Disease (The Union)
2024-01-01
|
| Series: | IJTLD Open |
| Subjects: | |
| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000001/art00008 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832592342288171008 |
|---|---|
| author | D. Nair P. Thekkur I. Mbithi M. Khogali R. Zachariah S. Dar Berger S. Satyanarayana A. M. V. Kumar I. Kathure J. Mwangi A. F. Bochner A. McClelland J. M. Chakaya A. D. Harries |
| author_facet | D. Nair P. Thekkur I. Mbithi M. Khogali R. Zachariah S. Dar Berger S. Satyanarayana A. M. V. Kumar I. Kathure J. Mwangi A. F. Bochner A. McClelland J. M. Chakaya A. D. Harries |
| author_sort | D. Nair |
| collection | DOAJ |
| description | BACKGROUND: The study assessed whether a “7-1-7” timeliness metric for screening and TB preventive therapy (TPT) could be implemented for household contacts (HHCs) of index patients with bacteriologically confirmed pulmonary TB under routine programmatic settings in Kenya. METHODS: A longitudinal cohort study conducted among index patients and their HHCs in 12 health facilities, Kiambu County, Kenya. RESULTS: Between January and June 2023, 95% of 508 index patients had their HHCs line-listed within 7 days of initiating anti-TB treatment (“First 7”). In 68% of 1,115 HHCs, screening outcomes were ascertained within 1 day of line-listing (“Next 1”). In 65% of 1,105 HHCs eligible for further evaluation, anti-TB treatment, TPT or a decision for no drugs was made within 7 days of screening (“Second 7”). Altogether, 62% of screened HHCs started TPT during the “7-1-7” period compared with 58% in a historical cohort. Main barriers to TPT uptake were HHCs not consulting clinicians, HHCs being unwilling to initiate TPT and drug shortages. Healthcare workers felt that a timeliness metric was valuable for streamlining HHC management and proposed “3-5-7” as a workable alternative. CONCLUSIONS: The national TB programme must generate awareness about TPT, ensure uninterrupted drug supplies and assess whether the “3-5-7” metric can be operationalised. |
| format | Article |
| id | doaj-art-3c205c2fae674c418aaaf915cc9e8813 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-3c205c2fae674c418aaaf915cc9e88132025-01-21T09:59:34ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-01-0111414910.5588/ijtldopen.23.05458Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in KenyaD. Nair0P. Thekkur1I. Mbithi2M. Khogali3R. Zachariah4S. Dar Berger5S. Satyanarayana6A. M. V. Kumar7I. Kathure8J. Mwangi9A. F. Bochner10A. McClelland11J. M. Chakaya12A. D. Harries13International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;Respiratory Society of Kenya, Nairobi, Kenya;Institute of Public Health, College of Medicine and Health Sciences, University of the United Arab Emirates, Al Ain, United Arab Emirates;United Nations Children Fund, United Nations Development Programme, World Bank, WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland;International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;Division of National TB, Leprosy and Lung Disease Programme, Ministry of Health, Nairobi,Department of Health, Kiambu County Government, Kiambu, Kenya;Resolve to Save Lives, New York City, NY, USA;Resolve to Save Lives, New York City, NY, USA;Respiratory Society of Kenya, Nairobi, Kenya;International Union Against Tuberculosis and Lung Disease (The Union), Paris, France;BACKGROUND: The study assessed whether a “7-1-7” timeliness metric for screening and TB preventive therapy (TPT) could be implemented for household contacts (HHCs) of index patients with bacteriologically confirmed pulmonary TB under routine programmatic settings in Kenya. METHODS: A longitudinal cohort study conducted among index patients and their HHCs in 12 health facilities, Kiambu County, Kenya. RESULTS: Between January and June 2023, 95% of 508 index patients had their HHCs line-listed within 7 days of initiating anti-TB treatment (“First 7”). In 68% of 1,115 HHCs, screening outcomes were ascertained within 1 day of line-listing (“Next 1”). In 65% of 1,105 HHCs eligible for further evaluation, anti-TB treatment, TPT or a decision for no drugs was made within 7 days of screening (“Second 7”). Altogether, 62% of screened HHCs started TPT during the “7-1-7” period compared with 58% in a historical cohort. Main barriers to TPT uptake were HHCs not consulting clinicians, HHCs being unwilling to initiate TPT and drug shortages. Healthcare workers felt that a timeliness metric was valuable for streamlining HHC management and proposed “3-5-7” as a workable alternative. CONCLUSIONS: The national TB programme must generate awareness about TPT, ensure uninterrupted drug supplies and assess whether the “3-5-7” metric can be operationalised.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000001/art00008kenyahhchousehold contact screeningtb preventive treatmentoperational researchtpt |
| spellingShingle | D. Nair P. Thekkur I. Mbithi M. Khogali R. Zachariah S. Dar Berger S. Satyanarayana A. M. V. Kumar I. Kathure J. Mwangi A. F. Bochner A. McClelland J. M. Chakaya A. D. Harries Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya IJTLD Open kenya hhc household contact screening tb preventive treatment operational research tpt |
| title | Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya |
| title_full | Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya |
| title_fullStr | Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya |
| title_full_unstemmed | Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya |
| title_short | Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya |
| title_sort | timeliness metrics for screening and preventing tb in household contacts of pulmonary tb patients in kenya |
| topic | kenya hhc household contact screening tb preventive treatment operational research tpt |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000001/art00008 |
| work_keys_str_mv | AT dnair timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT pthekkur timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT imbithi timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT mkhogali timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT rzachariah timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT sdarberger timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT ssatyanarayana timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT amvkumar timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT ikathure timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT jmwangi timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT afbochner timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT amcclelland timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT jmchakaya timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya AT adharries timelinessmetricsforscreeningandpreventingtbinhouseholdcontactsofpulmonarytbpatientsinkenya |