TY - JOUR
T1 - Willingness to take multidrug-resistant tuberculosis (MDR-TB) preventive therapy among adult and adolescent household contacts of MDR-TB index cases
T2 - An international multisite cross-sectional study
AU - Suryavanshi, Nishi
AU - Murrill, Matthew
AU - Gupta, Amita
AU - Hughes, Michael
AU - Hesseling, Anneke
AU - Kim, Soyeon
AU - Naini, Linda
AU - Jones, Lynne
AU - Smith, Betsy
AU - Gupte, Nikhil
AU - Dawson, Rodney
AU - Mave, Vidya
AU - Meshram, Sushant
AU - Mendoza-Ticona, Alberto
AU - Sanchez, Jorge
AU - Kumarasamy, Nagalingeswaran
AU - Comins, Kyla
AU - Conradie, Francesca
AU - Shenje, Justin
AU - Fontain, Sandy Nerette
AU - Garcia-Prats, Anthony
AU - Asmelash, Aida
AU - Nedsuwan, Supalert
AU - Mohapi, Lerato
AU - Lalloo, Umesh
AU - Ferreira, Ana Cristina Garcia
AU - Okeyo, Elisha
AU - Swindells, Susan
AU - Churchyard, Gavin
AU - Shah, N. Sarita
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background. Household contacts (HHCs) of individuals with multidrug-resistant tuberculosis (MDR-TB) are at high risk of infection and subsequent disease. There is limited evidence on the willingness of MDR-TB HHCs to take MDR-TB preventive therapy (MDR TPT) to decrease their risk of TB disease. Methods. In this cross-sectional study of HHCs of MDR-TB and rifampicin-resistant tuberculosis (RR-TB) index cases from 16 clinical research sites in 8 countries, enrollees were interviewed to assess willingness to take a hypothetical, newly developed MDR TPT if offered. To identify factors associated with willingness to take MDR TPT, a marginal logistic model was fitted using generalized estimating equations to account for household-level clustering. Results. From 278 MDR-TB/RR-TB index case households, 743 HHCs were enrolled; the median age of HHCs was 33 (interquartile range, 22-49) years, and 62% were women. HHC willingness to take hypothetical MDR TPT was high (79%) and remained high even with the potential for mild side effects (70%). Increased willingness was significantly associated with current employment or schooling (adjusted odds ratio [aOR], 1.83 [95% confidence interval {CI}, 1.07-3.13]), appropriate TB-related knowledge (aOR, 2.22 [95% CI, 1.23-3.99]), confidence in taking MDR TPT (aOR, 7.16 [95% CI, 3.33-15.42]), and being comfortable telling others about taking MDR TPT (aOR, 2.29 [95% CI, 1.29-4.06]). Conclusions. The high percentage of HHCs of MDR-TB/RR-TB index cases willing to take hypothetical MDR TPT provides important evidence for the potential uptake of effective MDR TPT when implemented. Identified HHC-level variables associated with willingness may inform education and counseling efforts to increase HHC confidence in and uptake of MDR TPT.
AB - Background. Household contacts (HHCs) of individuals with multidrug-resistant tuberculosis (MDR-TB) are at high risk of infection and subsequent disease. There is limited evidence on the willingness of MDR-TB HHCs to take MDR-TB preventive therapy (MDR TPT) to decrease their risk of TB disease. Methods. In this cross-sectional study of HHCs of MDR-TB and rifampicin-resistant tuberculosis (RR-TB) index cases from 16 clinical research sites in 8 countries, enrollees were interviewed to assess willingness to take a hypothetical, newly developed MDR TPT if offered. To identify factors associated with willingness to take MDR TPT, a marginal logistic model was fitted using generalized estimating equations to account for household-level clustering. Results. From 278 MDR-TB/RR-TB index case households, 743 HHCs were enrolled; the median age of HHCs was 33 (interquartile range, 22-49) years, and 62% were women. HHC willingness to take hypothetical MDR TPT was high (79%) and remained high even with the potential for mild side effects (70%). Increased willingness was significantly associated with current employment or schooling (adjusted odds ratio [aOR], 1.83 [95% confidence interval {CI}, 1.07-3.13]), appropriate TB-related knowledge (aOR, 2.22 [95% CI, 1.23-3.99]), confidence in taking MDR TPT (aOR, 7.16 [95% CI, 3.33-15.42]), and being comfortable telling others about taking MDR TPT (aOR, 2.29 [95% CI, 1.29-4.06]). Conclusions. The high percentage of HHCs of MDR-TB/RR-TB index cases willing to take hypothetical MDR TPT provides important evidence for the potential uptake of effective MDR TPT when implemented. Identified HHC-level variables associated with willingness may inform education and counseling efforts to increase HHC confidence in and uptake of MDR TPT.
KW - Contacts
KW - Drug resistance
KW - Preventive therapy
KW - Prophylaxis
KW - Tuberculosis
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U2 - 10.1093/cid/ciz254
DO - 10.1093/cid/ciz254
M3 - Article
C2 - 30919881
AN - SCOPUS:85077950738
SN - 1058-4838
VL - 70
SP - 436
EP - 445
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -