CISMAT is supported by Treatment Action Group (TAG) through a small grant to work on community household contacts, focusing on screening children under five who are in contact with bacteriologically confirmed TB patients for Tuberculosis Preventive Treatment (TPT) uptake. The project also aims to identify challenges and barriers affecting TPT, particularly the uptake of short-course regimens such as 3HP and 1HP. This is especially relevant for children and pregnant women due to a lack of funding support and the absence of approved national LTBI guidelines, which are crucial for the effective implementation of short-course TPT.

Through this project, the knowledge of caregivers, parents, and infected individuals is raised regarding TB treatment prevention (TPT) through household contact. TB support groups and community volunteers, trained for this purpose, conduct awareness education sessions within the community.

Childhood tuberculosis (TB) remains a significant concern, with high rates of undiagnosed cases and limited knowledge among healthcare providers. Several challenges contribute to this, including difficulty in collecting respiratory specimens from young children, the paucibacillary nature of childhood TB, which leads to low yields in microbiological tests, and the need for chest radiography—an unavailable resource in many areas. Furthermore, healthcare providers are often not well-trained in interpreting radiological images related to childhood TB. In Sierra Leone, TB treatment coverage is estimated at 72%, with a success rate of 89%. However, TB case notifications in children remain low, with only 1,591 cases reported out of an estimated 2,400 (66%). Access to GeneXpert testing is limited, with only 24% of TB cases tested, and X-ray availability is restricted to tertiary hospitals and a few district hospitals. Limited access to X-ray services is further compounded by the cost of the procedure and the transportation fees for patients.

It has been observed that household contact investigations and referral pathways can reduce barriers and address challenges in optimizing TB prevention and treatment for children. By conducting household contact investigations, we aim to improve the acceptability and demand for rifapentine-based TPT among households.