Management of Isoniazid Preventive Therapy in Southern Lima, Peru: An Analysis of Health Center Characteristics
Background: Prevention of TB through the use of preventive treatment is a critical activity in the elimination of TB. Health personnel are a key element in achieving proper management of isoniazid preventive therapy (IPT) for TB contacts. This study aims to determine the association between health center characteristics and indicators of TB contact care management with isoniazid preventive therapy in southern Lima. Methods: We conducted an ecological study. Through the review of medical
... of medical records, we identified children and adolescent contacts of tuberculosis patients, who initiated IPT between 2016 and 2018. We assessed bivariate associations between clinic staffing and IPT initiation and completion using binomial logistic regression with robust standard errors.Results: We included 977 contacts, among whom 69% took more than a week to start IPT and 41% did not complete IPT. For those who did successfully complete IPT, 58% were not medically evaluated with three follow-up appointments. While completion of IPT and 3 clinical appointments was better among health centers with more physicians and nurses, these differences were not statistically significant. Contact sex was associated with initiating IPT (p=0.005), and contact age was associated with completion of IPT (p=0.025) and completion of clinical evaluations (p=0.041). Conclusion: There are significant gaps in IPT management in health centers of southern Lima, Peru, but insufficient staffing of health centers may not be responsible. Further research is needed to identify how IPT management can be improved, including through improving training and staffing.