Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context
Summary: Background: Low adherence to treatment for tuberculosis infection (TBI) in children threatens tuberculosis (TB) control goals. This research focuses on children with close contact to TB and TBI. This study evaluated adherence to treatment of TBI using a comprehensive care strategy (CCS) fo...
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| Language: | English |
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Elsevier
2025-06-01
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| Series: | The Lancet Regional Health. Americas |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X25001048 |
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| author | Iader Rodríguez-Márquez Dione Benjumea-Bedoya Andrea Victoria Restrepo-Gouzy Claudia Patricia Beltrán-Arroyave Diana Marín Fernando Nicolás Montes-Zuluaga Juan Carlos Alzate-Ángel Lina Marcela Cadavid-Álvarez Lizeth Andrea Paniagua-Saldarriaga Teresa Realpe Yesenia Perea-Torres Lisandra María Arango-García Natalia Pérez-Doncel María Patricia Arbeláez-Montoya Jaime Robledo |
| author_facet | Iader Rodríguez-Márquez Dione Benjumea-Bedoya Andrea Victoria Restrepo-Gouzy Claudia Patricia Beltrán-Arroyave Diana Marín Fernando Nicolás Montes-Zuluaga Juan Carlos Alzate-Ángel Lina Marcela Cadavid-Álvarez Lizeth Andrea Paniagua-Saldarriaga Teresa Realpe Yesenia Perea-Torres Lisandra María Arango-García Natalia Pérez-Doncel María Patricia Arbeláez-Montoya Jaime Robledo |
| author_sort | Iader Rodríguez-Márquez |
| collection | DOAJ |
| description | Summary: Background: Low adherence to treatment for tuberculosis infection (TBI) in children threatens tuberculosis (TB) control goals. This research focuses on children with close contact to TB and TBI. This study evaluated adherence to treatment of TBI using a comprehensive care strategy (CCS) for close-contact children with pulmonary TB compared with standard of care (SOC). Methods: A prospective cohort study with a historical control group was conducted on children under five, who were close contacts of patients with bacteriologically confirmed pulmonary TB in three Colombian cities (study registration number: NCT04331262). The CCS comprised clinical evaluations, rifampicin for four months, multidisciplinary care, and logistical support, while the SOC followed program regulations with isoniazid for nine months. The primary outcome was the proportion of children completing 100% treatment during follow-up, and the secondary outcome was treatment-related adverse events (AEs). Findings: 213 children in the SOC group and 86 children in the CCS group were analyzed. The treatment adherence in the SOC group was 40·8% (95% CI 34%; 48%), while in the CCS group it was 76·7% (95% CI 66%; 85%). Children exposed to CCS had 87% higher probability of adherence to TBI treatment compared to SOC (RR 1·87; 95% CI 1·52; 2·31). The incidence of AEs was lower in the CCS group (n = 3) than in those receiving SOC (n = 24). Interpretation: The CCS increases adherence to treatment for TBI in children safely compared to SOC. Future cost-effectiveness studies will help implement this strategy in programmatic settings. Funding: Colombian Ministry of Science, Technology and Innovation. |
| format | Article |
| id | doaj-art-573a0d865968444482a6a7f00a2f61ea |
| institution | DOAJ |
| issn | 2667-193X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj-art-573a0d865968444482a6a7f00a2f61ea2025-08-20T03:14:47ZengElsevierThe Lancet Regional Health. Americas2667-193X2025-06-014610109410.1016/j.lana.2025.101094Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in contextIader Rodríguez-Márquez0Dione Benjumea-Bedoya1Andrea Victoria Restrepo-Gouzy2Claudia Patricia Beltrán-Arroyave3Diana Marín4Fernando Nicolás Montes-Zuluaga5Juan Carlos Alzate-Ángel6Lina Marcela Cadavid-Álvarez7Lizeth Andrea Paniagua-Saldarriaga8Teresa Realpe9Yesenia Perea-Torres10Lisandra María Arango-García11Natalia Pérez-Doncel12María Patricia Arbeláez-Montoya13Jaime Robledo14Grupo de Investigación en Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Antioquia, Medellín, Colombia; Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, Colombia; Unidad de Investigación Aplicada y Epidemiológica, Fundación Ideas Auna, Antioquia, Medellín, Colombia; Corresponding author. Grupo de Investigación en Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Antioquia, Medellín, Colombia.Grupo de Investigación en Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Antioquia, Medellín, Colombia; Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, Colombia; Grupo de Investigación en Salud Familiar y Comunitaria, Facultad de Ciencias de la Salud, Corporación Universitaria Remington, Antioquia, Medellín, ColombiaHospital Pablo Tobón Uribe, Antioquia, Medellín, ColombiaGrupo de Investigación Pediaciencias, Medicine School, Universidad de Antioquia, Antioquia, Medellín, Colombia; Clínica el Rosario, Antioquia, Medellín, Colombia; Clínica del Prado, Antioquia, Medellín, ColombiaGrupo de Investigación en Salud Pública, School of Health Sciences, Universidad Pontificia Bolivariana, Antioquia, Medellín, ColombiaTuberculosis Program, Secretariat of Health of Medellín, Antioquia, Medellín, ColombiaGrupo de Investigación en Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Antioquia, Medellín, ColombiaHospital Pablo Tobón Uribe, Antioquia, Medellín, ColombiaTuberculosis Program, Sectional Health Secretariat of Antioquia, Antioquia, Medellín, ColombiaUnidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, ColombiaUnidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, ColombiaUnidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, ColombiaUnidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, Colombia; Grupo de Investigación en Salud Pública, School of Health Sciences, Universidad Pontificia Bolivariana, Antioquia, Medellín, ColombiaGrupo de Investigación en Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Antioquia, Medellín, ColombiaUnidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Antioquia, Medellín, ColombiaSummary: Background: Low adherence to treatment for tuberculosis infection (TBI) in children threatens tuberculosis (TB) control goals. This research focuses on children with close contact to TB and TBI. This study evaluated adherence to treatment of TBI using a comprehensive care strategy (CCS) for close-contact children with pulmonary TB compared with standard of care (SOC). Methods: A prospective cohort study with a historical control group was conducted on children under five, who were close contacts of patients with bacteriologically confirmed pulmonary TB in three Colombian cities (study registration number: NCT04331262). The CCS comprised clinical evaluations, rifampicin for four months, multidisciplinary care, and logistical support, while the SOC followed program regulations with isoniazid for nine months. The primary outcome was the proportion of children completing 100% treatment during follow-up, and the secondary outcome was treatment-related adverse events (AEs). Findings: 213 children in the SOC group and 86 children in the CCS group were analyzed. The treatment adherence in the SOC group was 40·8% (95% CI 34%; 48%), while in the CCS group it was 76·7% (95% CI 66%; 85%). Children exposed to CCS had 87% higher probability of adherence to TBI treatment compared to SOC (RR 1·87; 95% CI 1·52; 2·31). The incidence of AEs was lower in the CCS group (n = 3) than in those receiving SOC (n = 24). Interpretation: The CCS increases adherence to treatment for TBI in children safely compared to SOC. Future cost-effectiveness studies will help implement this strategy in programmatic settings. Funding: Colombian Ministry of Science, Technology and Innovation.http://www.sciencedirect.com/science/article/pii/S2667193X25001048Latent tuberculosisComprehensive health careTreatment adherence and complianceMedication adherenceChildPreschool |
| spellingShingle | Iader Rodríguez-Márquez Dione Benjumea-Bedoya Andrea Victoria Restrepo-Gouzy Claudia Patricia Beltrán-Arroyave Diana Marín Fernando Nicolás Montes-Zuluaga Juan Carlos Alzate-Ángel Lina Marcela Cadavid-Álvarez Lizeth Andrea Paniagua-Saldarriaga Teresa Realpe Yesenia Perea-Torres Lisandra María Arango-García Natalia Pérez-Doncel María Patricia Arbeláez-Montoya Jaime Robledo Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context The Lancet Regional Health. Americas Latent tuberculosis Comprehensive health care Treatment adherence and compliance Medication adherence Child Preschool |
| title | Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context |
| title_full | Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context |
| title_fullStr | Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context |
| title_full_unstemmed | Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context |
| title_short | Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control groupResearch in context |
| title_sort | adherence to treatment for tuberculosis infection in children using a comprehensive care strategy a prospective cohort study with a historical control groupresearch in context |
| topic | Latent tuberculosis Comprehensive health care Treatment adherence and compliance Medication adherence Child Preschool |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X25001048 |
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