Prevalence And Factors Associated With Initiation Of Isoniazid Preventive Therapy Among Children Aged Below Five Years in Kisumu County

Abstract

Tuberculosis is a crucial global public health problem which ranks second to HIV/AIDS as cause of mortality and is the leading cause of morbidity and mortality among people living with HIV/AIDS. Kenya is burdened with an estimated TB prevalence of 266 per 100,000. 52.5% of cases and 5.2% TB associated mortality occur among children below 5 years. Kisumu County is a TB and HIV endemic zone with a prevalence of 208-306 per 100,000 and 19.3% respectively. Children below 5 years who are household contacts with sputum positive pulmonary tuberculosis persons should be initiated on Isoniazid Preventive Therapy (IPT). This practice remains low hampering the ‘END TB’ strategies in Kisumu County. This descriptive Cross-Sectional study determined prevalence and factors associated with IPT initiation among children below 5 years living in Kisumu County. Significance was set at p<0.05 and analysis done using STATA. Prevalence was established as [70.2%; 95% C.I (63.0-76.6)] with highest uptake among females [72.6%; 95% C.I (67.7-80.7)] against [67.5%; 95 % C.I (56.376.9)] in males. Caregivers with Higher level of education [aPR=1.36; 95% C.I (1.04-1.78)] were more likely to initiate children on IPT compared to those with incomplete primary education. Respondents of younger age [aPR=1.48; 95% C.I (1.27-1.73)] were more likely to initiate children on IPT compared to those > 40 years. The study concluded that IPT uptake is still unexpectedly low and this may be a major driver of TB infection in young children. The study recommends that the Ministry of health should advocate for health promotion activities unlimited to sensitization. Further studies need to examine the correlates of adherence and predictors of missed opportunity to IPT initiation.