Factors associated with initiation of TB preventive therapy

BACKGROUND This study aimed to explore the factors associated with TB preventive therapy (TPT) uptake among household contacts of TB patients in the southern region of Bangladesh, a high-TB-burden country. METHODS This cross-sectional study was conducted among household contacts of pulmonary TB cases who were eligible for TPT in Khulna District, Bangladesh, between September and October 2023. A total of 378 participants were selected randomly from six organisations providing Directly Observed Therapy Short-course (DOTS) services, using DOTS centre record books. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire digitised in Kobo Toolbox. RESULTS Among the participants, 64.8% had initiated TPT. Age above 16 years (adjusted odds ratio [aOR]: 3.61, 95% confidence interval [CI]: 1.88-7.02), education level of SSC and above (aOR: 4.27, 95% CI: 2.36-7.87), knowledge about TPT (aOR: 2.55, 95% CI: 1.27-5.13), and receiving TPT counselling (aOR: 16.3, 95% CI: 4.03-112.0) emerged as strong positive predictors of TPT uptake. Urban residence showed lower odds (aOR: 0.25, 95% CI: 0.09-0.59) compared to semi-urban areas. The primary barriers to TPT uptake were fear of side effects (40.6%), drug unavailability (36.1%), and lack of interest (29.3%). CONCLUSION Successful TPT implementation requires strengthening health communication, ensuring drug availability, and addressing socio-economic barriers, particularly in urban areas. .