Tuberculosis Preventive Therapy Adherence and Factors Associated with it among Household Contacts of Tuberculosis Patients in Western Uttar Pradesh: A Prospective study

Introduction: Tuberculosis (TB) remains a significant global health challenge, with India bearing the highest burden. Tuberculosis Preventive Therapy (TPT) is a critical strategy to prevent latent TB infection (LTBI) from progressing to active disease, particularly among household contacts (HHCs) of pulmonary TB patients. Objective: This study evaluates the completion rate and factors influencing TPT adherence in Agra district, India. Methods: A community based prospective follow up study was conducted from January 2024 to December 2024 in two randomly selected Tuberculosis Units (TU) (Lohamandi and Bichpuri) in Agra district. A total of 360 Household contacts (HHC) were enrolled in the study. Data was collected via a pilot-tested, semi-structured questionnaire based on the Programmatic Management of Tuberculosis Preventive Treatment (PMTPT) guidelines. Participants were followed for six months to assess TPT completion, adverse effects and factors influencing compliance of TPT. Results: The TPT completion rate was 55.3%, with 40.9% lost to follow-up and 3.8% discontinuing due to adverse effects. Factors significantly associated with completion included higher education, occupation, socio-economic status, regular follow-up, and awareness of TPT importance (all p<0.001). Common barriers to adherence were lack of perceived need (41.9%) and forgetfulness (38.7%). Reported side effects were minimal, including lethargy (2.8%) and skin rashes (1.1%). Conclusion: Study highlights that TPT adherence in Agra district is slightly over half hindered by low awareness and poor follow-up. Strengthening education, routine monitoring, and addressing socio-economic barriers are essential to enhancing TPT outcomes and achieving India's TB elimination target by 2025.