Low preventive treatment initiation and completion among young children contacts of active TB in Tbilisi, Georgia.

Background: Within the Georgian National Tuberculosis Program (NTP), TB preventive treatment (TPT) is recommended for all child TB contacts ≤5 years. To assess adherence to this guidance, we evaluated the care cascade for the treatment of latent TB infection among children ≤5 years at the National Center for Tuberculosis and Lung Disease (NCTLD).

Methods: We performed a cohort study among children ≤5 years evaluated at NCTLD during 2012-2014 as a contact of active pulmonary TB people. We recorded how many patients were recommended to start isoniazid preventive therapy (IPT) and how many initiated and completed treatment.

Results: Among 172 contacts of active TB people who visited the NCTLD between 2012 and 2014, 134 (74%) were contacts to drug-susceptible TB index cases. Among children recommended to start IPT (n= 94), 50 (51%) initiated treatment, and 16 (33%) completed IPT. Overall, 4 (4%) contacts developed active TB during 1,483 person-years of follow-up (mean 8.6 years), including 1 in the IPT group who did not complete therapy and 3 (6%) in the non-IPT group.

Conclusions: Our findings highlight low rates of LTBI treatment recommendation, TPT initiation and completion among young children who were TB contacts in Georgia, highlighting the need for improved monitoring and enhanced treatment programs and regimens.