Isoniazid preventive treatment in children in two districts of South India: does practice follow policy?

Int J Tuberc Lung Dis. 2014 Aug;18(8):919-24. doi: 10.5588/ijtld.14.0072.


Setting: Two districts of Tamil Nadu, India

Objectives: To determine the proportion of household contacts aged <6 years of patients with tuberculosis (TB) with positive sputum microscopy results who initiated and completed isoniazid preventive treatment (IPT), and to determine reasons for non-initiation and non-completion of IPT.

Design: Household visits were conducted on a random sample of adult patients registered during January-June 2012 to identify household contacts aged <6 years.

Results: Among 271 children living with 691 index patients, 218 (80%) were evaluated and 9 (4%) were diagnosed with TB. Of 209 remaining contacts, 70 (33%) started IPT and 16 (22.9%) completed a full course of IPT. Of 139 contacts who did not start IPT, five developed TB disease. Reasons for non-initiation of IPT included no home visit by the field staff (19%) and no education about IPT (61%). Reasons for non-completion included isoniazid not provided (52%) and long duration of treatment (28%).

Conclusion: This study shows that Revised National TB Programme guidance was not being followed and IPT implementation was poor. Poor IPT uptake represents a missed opportunity to prevent future TB cases. Provision of IPT may be improved through training, improved logistics and enhanced supervision and monitoring.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Contact Tracing
  • Cross-Sectional Studies
  • Female
  • Health Policy*
  • Humans
  • India / epidemiology
  • Infant
  • Isoniazid / therapeutic use*
  • Male
  • National Health Programs
  • Sputum / microbiology
  • Tuberculosis / epidemiology
  • Tuberculosis / prevention & control*


  • Antitubercular Agents
  • Isoniazid