Caregivers’ knowledge and perceptions are associated with children’s TB preventive treatment completion

SETTING: Forty-six health centers in south Lima, Peru.

OBJECTIVE: To assess the association between caregivers’ knowledge and perceptions around isoniazid preventive therapy (IPT) and whether their children complete IPT.

DESIGN: We conducted a retrospective medical record review of children who initiated IPT during 2017–2018. We administered structured surveys to caregivers of the children about their knowledge about and perceptions of IPT. We used a modified Poisson regression to determine factors associated with IPT completion.

RESULTS: We included 550 children, of whom 31% did not complete IPT. Independent factors associated with not completing IPT were low caregiver knowledge about TB and IPT (adjusted risk ratio [aRR] 1.41, 95% CI 1.06–1.78), low caregiver perception of the importance of IPT (aRR 1.76, 95% CI 1.30–2.39), low caregiver satisfaction with the health services (aRR 1.57, 95% CI 1.14–2.16), experience of adverse events (aRR 2.08, 95% CI 1.51–2.87), and living in a household with moderate or severe family dysfunction (aRR 1.53, 95% CI 1.07–2.19).

CONCLUSION: IPT completion among children was associated with the knowledge and perceptions of their caregivers, as well as the experience of adverse events. To improve IPT completion among children, health care providers should prioritize education and counseling for caregivers, promote positive interpersonal relationships with them, and monitor adverse events.