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Willingness to Take Multidrug-resistant Tuberculosis (MDR-TB) Preventive Therapy Among Adult and Adolescent Household Contacts of MDR-TB Index Cases: An International Multisite Cross-sectional Study.


ABSTRACT:

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.

SUBMITTER: Suryavanshi N 

PROVIDER: S-EPMC7188234 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Willingness to Take Multidrug-resistant Tuberculosis (MDR-TB) Preventive Therapy Among Adult and Adolescent Household Contacts of MDR-TB Index Cases: An International Multisite Cross-sectional Study.

Suryavanshi Nishi N   Murrill Matthew M   Gupta Amita A   Hughes Michael M   Hesseling Anneke A   Kim Soyeon S   Naini Linda L   Jones Lynne L   Smith Betsy B   Gupte Nikhil N   Dawson Rodney R   Mave Vidya V   Meshram Sushant S   Mendoza-Ticona Alberto A   Sanchez Jorge J   Kumarasamy Nagalingeswaran N   Comins Kyla K   Conradie Francesca F   Shenje Justin J   Nerette Fontain Sandy S   Garcia-Prats Anthony A   Asmelash Aida A   Nedsuwan Supalert S   Mohapi Lerato L   Lalloo Umesh U   Cristina Garcia Ferreira Ana A   Okeyo Elisha E   Swindells Susan S   Churchyard Gavin G   Shah N Sarita NS  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20200101 3


<h4>Background</h4>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.<h4>Methods</h4>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 t  ...[more]

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