{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:13:36Z","timestamp":1785528816649,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tuberculosis remains a significant public health issue, particularly among children who are in close contact with tuberculosis patients. India accounts for a large proportion of global tuberculosis cases. Despite global recommendations for Isoniazid Preventive Therapy to prevent latent tuberculosis infection from progressing to active disease, the initiation and adherence to Isoniazid Preventive Therapy remain suboptimal, especially in high\u2010burden settings. Understanding the barriers to Isoniazid Preventive Therapy implementation is crucial to improving treatment outcomes and achieving tuberculosis elimination goals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to quantify the uptake of isoniazid among children under 6\u2009years who were started on Isoniazid Preventive Therapy and to identify the challenges from the perspectives of caregivers and healthcare providers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted in a slum in Mumbai, India, from June to December 2023, using a mixed\u2010methods design. The quantitative phase involved a house\u2010to\u2010house survey, covering all 96 contacts started on Isoniazid Preventive Therapy in 2022, using a semi\u2010structured questionnaire. The qualitative phase included key informant interviews with healthcare providers and in\u2010depth interviews with caregivers. Quantitative data were analysed using Fisher's exact test and chi\u2010square test, while qualitative data were analysed thematically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 96 children, 11 (11.45%) completed therapy, with an average treatment duration of 2.5\u2009months. Quantitative findings highlighted fear of side effects and family migration as major reasons for discontinuation. Completion of chemoprophylaxis was significantly associated with factors like male gender, support from extended family, home visits by tuberculosis health staff, and shorter travel time (under 30\u2009min) to the tuberculosis unit. Qualitative data revealed challenges across themes of supply, staff, training, services, and adherence. Key challenges included lack of awareness, unavailability of isoniazid in syrup form, inadequate training for health workers, weak program monitoring, insufficient staffing, and fears related to tuberculosis exposure during outpatient department visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Effective counselling, regular follow\u2010ups, availability of medications in syrup form, increasing staffing based on case burden, timely training of staff, strengthening program monitoring, and ensuring infection control in tuberculosis outpatient departments are critical to achieving successful completion of isoniazid preventive therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.14072","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T04:56:26Z","timestamp":1735188986000},"page":"93-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Implementation of isoniazid preventive therapy among children living with diagnosed pulmonary tuberculosis patients: A mixed methods study from Mumbai, India"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8618-5593","authenticated-orcid":false,"given":"P. A.","family":"Sreevidya","sequence":"first","affiliation":[{"name":"Department of Community Medicine Seth GSMC &amp; KEM Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8968-4258","authenticated-orcid":false,"given":"Shrikala","family":"Acharya","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Seth GSMC &amp; KEM Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5746-9198","authenticated-orcid":false,"given":"Mayuri Umesh","family":"Raul","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Seth GSMC &amp; KEM Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6787-449X","authenticated-orcid":false,"given":"Aparna","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Seth GSMC &amp; KEM Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Tuberculosis [Internet]. [cited 2023 Apr 15]. Available from.https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis"},{"key":"e_1_2_7_3_1","unstructured":"INDIA TB REPORT 2023 [Internet]. Available from.http:\/\/www.tbcindia.gov.in"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.044255"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05449-x"},{"key":"e_1_2_7_6_1","unstructured":"WHO Library Cataloguing\u2010in\u2010Publication Data Global tuberculosis report 2015. 2015 [cited 2023 Apr 15]; Available from.www.who.int"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30166-5"},{"key":"e_1_2_7_8_1","unstructured":"Latent tuberculosis infection updated and consolidated guidelines for programmatic management."},{"key":"e_1_2_7_9_1","unstructured":"Global strategy and targets for tuberculosis prevention care and control after 2015 Report by the Secretariat."},{"key":"e_1_2_7_10_1","unstructured":"Global tuberculosis report 2023 [Internet]. 2023. Available from.https:\/\/iris.who.int\/"},{"key":"e_1_2_7_11_1","unstructured":"Guidelines for Programmatic Management of TB Preventive Treatment in India.2021."},{"key":"e_1_2_7_12_1","first-page":"33","article-title":"Detection of tuberculosis in children of new risk groups and efficacy of chemoprophylaxis","volume":"6","author":"Mitinskaia LA","year":"1996","journal-title":"Probl Tuberk [Internet]"},{"issue":"11","key":"e_1_2_7_13_1","first-page":"677","article-title":"Efficacy of tuberculosis contacts investigation and treatment, especially of preventive therapy in infants and young children","volume":"78","author":"Kondo S","year":"2003","journal-title":"Kekkaku"},{"issue":"1","key":"e_1_2_7_14_1","first-page":"1","article-title":"Chemoprophylaxis for children exposed to tuberculosis","volume":"68","author":"Iwasaki T","year":"1993","journal-title":"Kekkaku"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-91"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0155525"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30216-X"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-07062-6"},{"issue":"4","key":"e_1_2_7_19_1","first-page":"274","article-title":"Isoniazid preventive therapy among children living with tuberculosis patients: is it working? A mixed\u2010method study from Bhopal, India","volume":"63","author":"Singh AR","year":"2017","journal-title":"J Trop Pediatr [Internet]"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2021.03.005"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.14.0072"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.14072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T08:36:33Z","timestamp":1739781393000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.14072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,25]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/tmi.14072"],"URL":"https:\/\/doi.org\/10.1111\/tmi.14072","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,25]]},"assertion":[{"value":"2024-12-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}