Abandonment of Treatment for Latent Tuberculosis Infection and Socioeconomic Factors in Children and Adolescents: Rio De Janeiro, Brazil

PLoS One. 2016 May 5;11(5):e0154843. doi: 10.1371/journal.pone.0154843. eCollection 2016.

Abstract

Background: Routine data on the use of isoniazid preventive therapy (IPT) in children and adolescents are scarce in high tuberculosis (TB) burden countries.

Objective: To describe the factors related to abandonment of IPT in children and adolescents with latent tuberculosis infection (LTBI) receiving routine care.

Methods: Retrospective (2005-2009) descriptive study of 286 LTBI cases with indication of IPT and serviced at a pediatric hospital in the State of Rio de Janeiro, Brazil. Survival analysis of the risk of abandonment of IPT over six months was performed, including multivariate analysis using the Cox proportional hazards model.

Results: Out of the 245 cases of LTBI included, 62 abandoned IPT (25.3%; 95% CI: 20%-31%). On multivariate analysis, the variables related to the IPT abandonment hazard ratio were the Human Development Index (HDI) (hazard ratio-HR: 0.004; 0.000-0.569) of the place of residence and the contact with adults that were not undergoing anti-TB treatment (HR: 7.30; 1.00-53.3).

Conclusion: This study reveals the relevance of the relation of abandonment of IPT to the socioeconomic conditions at the place of residence and poor adherence to the active TB treatment. Educational measures to stimulate preventive treatment of child contacts and curative treatment of index cases should target the full familial setting.

MeSH terms

  • Adolescent
  • Antitubercular Agents / therapeutic use*
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Isoniazid / therapeutic use*
  • Latent Tuberculosis / drug therapy*
  • Latent Tuberculosis / epidemiology
  • Longitudinal Studies
  • Male
  • Retrospective Studies
  • Socioeconomic Factors*

Substances

  • Antitubercular Agents
  • Isoniazid

Associated data

  • Dryad/10.5061/dryad.1886t

Grants and funding

The authors have no support or funding to report.