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Child contact management in high tuberculosis burden countries: A mixed-methods systematic review
Library Publications and Presentations
  • Daria Szkwarko, University of Massachusetts Medical School
  • Yael Hirsch-Moverman, Columbia University
  • Lienki Du Plessis, Stellenbosch University
  • Karen Du Preez, Stellenbosch University
  • Catherine W. Carr, University of Massachusetts Medical School
  • Anna M. Mandalakas, Baylor College of Medicine
UMMS Affiliation
Department of Family Medicine and Community Health; Lamar Soutter Library
Document Type

Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide. Considering the World Health Organization recommendation to implement child contact management (CCM) for TB, we conducted a mixed-methods systematic review to summarize CCM implementation, challenges, predictors, and recommendations. We searched the electronic databases of PubMed/MEDLINE, Scopus, and Web of Science for studies published between 1996-2017 that reported CCM data from high TB-burden countries. Protocol details for this systematic review were registered on PROSPERO: International prospective register of systematic reviews (#CRD42016038105). We formulated a search strategy to identify all available studies, published in English that specifically targeted a) population: child contacts (<15 >years) exposed to TB in the household from programmatic settings in high burden countries (HBCs), b) interventions: CCM strategies implemented within the CCM cascade, c) comparisons: CCM strategies studied and compared in HBCs, and d) outcomes: monitoring and evaluation of CCM outcomes reported in the literature for each CCM cascade step. We included any quantitative, qualitative, mixed-methods study design except for randomized-controlled trials, editorials or commentaries. Thirty-seven studies were reviewed. Child contact losses varied greatly for screening, isoniazid preventive therapy initiation, and completion. CCM challenges included: infrastructure, knowledge, attitudes, stigma, access, competing priorities, and treatment. CCM recommendations included: health system strengthening, health education, and improved preventive therapy. Identified predictors included: index case and clinic characteristics, perceptions of barriers and risk, costs, and treatment characteristics. CCM lacks standardization resulting in common challenges and losses throughout the CCM cascade. Prioritization of a CCM-friendly healthcare environment with improved CCM processes and tools; health education; and active, evidence-based strategies can decrease barriers. A focused approach toward every aspect of the CCM cascade will likely diminish losses throughout the CCM cascade and ultimately decrease TB related morbidity and mortality in children.

  • Child health,
  • Tuberculosis,
  • Tuberculosis diagnosis and management,
  • Health screening,
  • Isoniazid,
  • Health education and awareness,
  • Systematic reviews,
  • Qualitative studies
Rights and Permissions
Copyright: © 2017 Szkwarko et al.
DOI of Published Version
PLoS One. 2017 Aug 1;12(8):e0182185. doi: 10.1371/journal.pone.0182185. eCollection 2017. Link to article on publisher's website
Related Resources
Link to article in PubMed
PubMed ID
Creative Commons License
Creative Commons Attribution 4.0
Citation Information
Daria Szkwarko, Yael Hirsch-Moverman, Lienki Du Plessis, Karen Du Preez, et al.. "Child contact management in high tuberculosis burden countries: A mixed-methods systematic review" Vol. 12 Iss. 8 (2017) ISSN: 1932-6203
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