Contact screening and chemoprophylaxis in India 's Revised Tuberculosis Control Programme: a situational analysis.

Banu Rekha, V.V.; Jagarajamma, K.; Wares, F.; Chandrasekaran, V.; Swaminathan, S.

International Journal of Tuberculosis and Lung Disease; 2009; 13; 1507–1512.

Summary: Background: India's Revised National Tuberculosis Control Programme (RNTCP) recommends screening of all household contacts of smear-positive pulmonary tuberculosis (PTB) cases for tuberculosis (TB) disease, and 6-month isoniazid preventive therapy (IPT) for asymptomatic children aged < 6 years.

Objective: To assess the implementation of child contact screening and IPT administration under the RNTCP.

Methods: A cross-sectional study conducted in four randomly selected TB units (TUs), two in an urban ( Chennai City ) and two in a rural (Vellore District) area of Tamil Nadu, South India , from July to September 2008. The study involved the perusal of TB treatment cards of source cases (new or retreatment smear-positive PTB patients started on treatment), interview of source cases and focus group discussions (FGDs) among health care workers.

Results: Interviews of 253 PTB patients revealed that of 220 contacts aged < 14 years, only 31 (14%) had been screened for TB, and that of 84 household children aged < 6 years, only 16 (19%) had been initiated on IPT. The treatment cards of source cases lacked documentation of contact details. FGDs revealed greater TB awareness among urban health care workers, but a lack of detailed knowledge about procedures.

Conclusion: Provision for documentation using a separate IPT card and focused training may help improve the implementation of contact screening and IPT.

Keywords: contact screening; IPT; RNTCP; chemoprophylaxis; children

Back to List of publications / Home