A six months follow-up on children less than 6 years old in contact with smear positive tuberculosis patients, Varamin city,Tehran,Iran.

Abstract

Abstract:

Background: Current international guidelines recommend 6-9 months of Isoniazid (INH) preventive chemotherapy to prevent the development of active tuberculosis in children exposed to smear positive tuberculosis patients. The purpose of this study was to determine adherence to six months of supervised INH prophylaxis and outcome in children with household exposure to an adult pulmonary tuberculosis index case in Varamin city, Tehran, Iran.

Methods: A descriptive study (Cross-sectional) was conducted among household contacts in Varamin city, between 1997- 1998. All children <6 years old in household contact with an adult pulmonary tuberculosis index case were screened for tuberculosis and given supervised INH preventive chemotherapy once active tuberculosis was excluded . Adherence and outcome were monitored.

Results: In total, 31 index cases and 128 household contact cases were identified; 23 (18%)children <6 years old experienced household exposure, who were fully evaluated. two children were treated for active tuberculosis and 15 (12%)children received preventive chemotherapy. Positive smear results in index cases were as follow: 19 cases, 1+; 5 cases, 2+; 7 cases, 3+ .A comparisons of positive smears in the index cases with need for prophylaxis of contact cases shows that the majority of contacts requiring prophylaxis had close contact with the 1+  index cases. All children who received preventive chemotherapy, completed 6 months of supervised INH prophylaxis.

Conclusion: Strategy of six months of supervised INH chemoprophylaxis

is successful , particularly in children who are at high risk to progress to disease following exposure.

Key Words: Tuberculosis, Contacts, Follow-up, Chemoprophylaxis