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Decentralising TB diagnosis and contact management: impact on detection and preventive treatment in children
Article de revue scientifique   Avec comité de lecture

Decentralising TB diagnosis and contact management: impact on detection and preventive treatment in children

Vivien Delmas, Anca Vasiliu, Boris Tchakounte Youngui, Bob Ssekyanzi, Albert Kuate Kuate, Stavia Turyahabwe, L. Simo, Richard Okello, Martina Casenghi, Boris Kévin Tchounga, …
International Journal of Tuberculosis and Lung Disease, Vol.29(7), p.312-317
27/06/2025
PMID: 40579765

Résumé

paediatric TB tuberculosis diagnosis TPT Humans Child, Preschool Cameroon Isoniazid Mass Screening Contact Tracing Infant Rifampin Uganda Female Male Antitubercular Agents Tuberculosis
BACKGROUND: The ‘CaP-TB’ project enhanced paediatric TB care through decentralized services, including screening, specimen collection, chest X-rays and implementation of the three-month rifampicin-isoniazid regimen for TB preventive treatment (TPT). In Cameroon and Uganda, it also included community-based child contact management through the ‘CONTACT’ study. We assessed the impact of CaP-TB project on TB detection and TPT outcomes in children, focusing on facilities included in ‘CONTACT’ study.METHODS: Using a before-after design with aggregated data, we compared the proportion of children among all notified TB patients and the TPT completion rate for child contacts < 5 years old between a pre- (March 2018–March 2019) and per-intervention (September 2020–September 2021) periods. During the intervention, half of the facilities implemented community-based child contact management.RESULTS: The proportion of children among all notified TB patients increased from 4.8% (113/2373) to 11% (276/2512) during the intervention (odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.79–2.84). The number of children initiated on TPT increased from 105 to 841 and TPT completion rate from 55.2% (58/105) to 94.9% (798/841), (OR = 33.4, CI: 16.39–68.06).CONCLUSION: Decentralizing and strengthening diagnosis and contact management can help overcome barriers to effective TB detection and TPT coverage in children.

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