{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:03:56Z","timestamp":1785434636017,"version":"3.56.0"},"reference-count":27,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0The World Health Organization recommends 6 months of isoniazid preventive therapy (IPT) to children who have been exposed to tuberculosis (TB) patients to prevent active TB. Although IPT is an efficacious intervention, it is underutilised.\nAim:\u00a0The aim of this study was to examine factors associated with the completion of IPT among children under 5 years who have been exposed to TB patients.\nSetting:\u00a0This was a secondary data analysis; the primary study was conducted in Blantyre, Malawi.\nMethods:\u00a0This study was a secondary analysis of a randomised controlled trial with follow-up at 3 months and 6 months. Univariable and multivariable logistic regression models were used to identify factors associated with the completion of IPT.\nResults:\u00a0One hundred and twenty-eight children were included, of whom 58 (45.3%) completed IPT. Index patient human immunodeficiency virus (HIV)-positive status (adjusted odds ratio [aOR] = 0.39, 95% confidence interval [CI]: 0.16\u20130.94) and longer distance (&gt; 5 km) (aOR = 0.25, 95% CI: 0.07\u20130.89) were associated with lower IPT completion. Wealth status, household health-seeking decision maker and type of contact tracing were associated with higher IPT completion, with aOR = 3.42 (95% CI: 1.19\u20139.88) for children coming from households of high wealth status, aOR = 3.17 (95% CI: 1.19\u20138.42) in which the health-seeking decision maker was the parent compared to other guardians, and aOR = 3.13 (95% CI: 1.25\u20137.84) for children who were identified through patient-conducted tracing compared to routine contact tracing.\nConclusion:\u00a0Human immunodeficiency virus status, wealth status, household health-seeking decision maker, proximity to health facility and type of contact tracing are key determinants of IPT completion among children.\nContribution:\u00a0This study provides valuable insights into the factors that affect the completion of IPT. By addressing these factors, completion of IPT can be improved, thereby preventing TB among children.<\/jats:p>","DOI":"10.4102\/jphia.v17i1.1528","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:32:10Z","timestamp":1773383530000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with completion of 6 months of isoniazid preventive therapy among under-five children exposed to tuberculosis patients in Blantyre, Malawi"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-6678","authenticated-orcid":false,"given":"Glory","family":"Mzama","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7025-4992","authenticated-orcid":false,"given":"Kruger","family":"Kaswaswa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00khnq787","id-type":"ROR","asserted-by":"publisher"}],"name":"Kamuzu University of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4344-0842","authenticated-orcid":false,"given":"Tobias","family":"Chirwa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6608-6930","authenticated-orcid":false,"given":"Juliana","family":"Kagura","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1607-1685","authenticated-orcid":false,"given":"Latifat","family":"Ibisomi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"ref0","unstructured":"World Health Organization. Roadmap towards ending TB in children and adolescents [homepage on the Internet]. Geneva: WHO; 2018 [cited 2022 Oct 22]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789241514668"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Van Ginderdeuren E, Bassett J, Hanrahan C, Mutunga L, Van Rie A. Gaps in the tuberculosis preventive therapy care cascade in children in contact with TB. Paediatr Int Child Health. 2021;41(4):237\u2013246. https:\/\/doi.org\/10.1080\/20469047.2021.1971360","DOI":"10.1080\/20469047.2021.1971360"},{"key":"ref2","unstructured":"Mzama G, editor. Factors associated with completion of isoniazid preventive therapy among under-five children exposed to TB in Blantyre, Malawi. 8th South African TB Conference; 2024 May 17; Durban, South Africa [homepage on the Internet]. 2024 [cited 2025 Oct 13]. Available from: https:\/\/tbconference.co.za\/wp-content\/uploads\/2024\/08\/factors-associated-GloryMzama_SA-TB-Conference-Slides_17May2024.pdf"},{"key":"ref3","unstructured":"Malawi Ministry of Health. National tuberculosis control programme: Annual Report. Lilongwe: Malawi Government Press; 2020."},{"key":"ref4","unstructured":"World Health Organization. WHO consolidated guidelines on tuberculosis: Tuberculosis preventive treatment [homepage on the Internet]. World Health Organization; 2020 [cited 2022 Oct 22]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240001503"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Ngugi SK, Muiruri P, Odero T, Gachuno O. Factors affecting uptake and completion of isoniazid preventive therapy among HIV-infected children at a national referral hospital, Kenya: A mixed quantitative and qualitative study. 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Effect of patient-delivered household contact tracing and prevention for tuberculosis: A household cluster-randomised trial in Malawi. PLoS One. 2022;17(9):e0269219. https:\/\/doi.org\/10.1371\/journal.pone.0269219","DOI":"10.1371\/journal.pone.0269219"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Mindu C, L\u00f3pez-Varela E, Alonso-Menendez Y, et al. Caretakers\u2019 perspectives of paediatric TB and implications for care-seeking behaviours in Southern Mozambique. PLos One. 2017;12(9):e0182213. https:\/\/doi.org\/10.1371\/journal.pone.0182213","DOI":"10.1371\/journal.pone.0182213"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Birungi FM, Graham S, Uwimana J, Van Wyk B. Assessment of the isoniazid preventive therapy uptake and associated characteristics: A cross-sectional study. 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Completion of 6-mo isoniazid preventive treatment among eligible under six children: A cross-sectional study, Lagos, Nigeria. 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