Implementing a tuberculosis child contact register to quantify children at risk for tuberculosis and HIV in Eldoret, Kenya

Abstract

Objective: To identify TB exposed children through the implementation of a child contact register (CCR). To assess the demographics of children exposed to TB and the potential for initiation of isoniazid preventive therapy (IPT) in this cohort. Methods: A CCR was implemented in routine care with health care workers querying index cases regarding child contacts. Data were retrospectively analyzed. Results: In 12 months, the CCR revealed 580 children exposed to TB. Of these, 58% were exposed to smear-positive TB and 30% were aged <5 years. Of those exposed to smear-positive TB, 15% may have qualified for IPT initiation. Only 6 (1%) child contacts were screened for TB disease. More than 50% of the children with human immunodeficiency virus (HIV) positive mothers had not been HIV tested. CONCLUSION: Implementation of a CCR is a possible first step in child contact identification and management, which requires minimal resources and identifies children at risk for TB and HIV. Child contact screening and IPT initiation remain a challenge, and additional strategies are urgently needed.