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

Nishi Suryavanshi, Matthew Murrill, Amita Gupta, Michael Hughes, Anneke Hesseling, Soyeon Kim, Linda Naini, Lynne Jones, Betsy Smith, Nikhil Gupte, Rodney Dawson, Vidya Mave, Sushant Meshram, Alberto Mendoza-Ticona, Jorge Sanchez, Nagalingeswaran Kumarasamy, Kyla Comins, Francesca Conradie, Justin Shenje, Sandy Nerette FontainAnthony Garcia-Prats, Aida Asmelash, Supalert Nedsuwan, Lerato Mohapi, Umesh Lalloo, Ana Cristina Garcia Ferreira, Elisha Okeyo, Susan Swindells, Gavin Churchyard, N. Sarita Shah

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)436-445
Number of pages10
JournalClinical Infectious Diseases
Volume70
Issue number3
DOIs
StatePublished - Feb 1 2020

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Keywords

  • Contacts
  • Drug resistance
  • Preventive therapy
  • Prophylaxis
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Suryavanshi, N., Murrill, M., Gupta, A., Hughes, M., Hesseling, A., Kim, S., Naini, L., Jones, L., Smith, B., Gupte, N., Dawson, R., Mave, V., Meshram, S., Mendoza-Ticona, A., Sanchez, J., Kumarasamy, N., Comins, K., Conradie, F., Shenje, J., ... Shah, N. S. (2020). 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. Clinical Infectious Diseases, 70(3), 436-445. https://doi.org/10.1093/cid/ciz254