Window Period Prophylaxis for Children Exposed to Tuberculosis, Houston, Texas, USA, 2007–2017

Abstract

In this retrospective study, we assessed the safety of window period prophylaxis and proportion of tuberculin skin test (TST) conversions in children <5 years of age who were exposed to an adult with tuberculosis disease during 2007–2017. Children included in this study had unremarkable examination and chest radiograph findings and negative test results for TB infection. In total, 752 children (41% cohabitating with the index patient) received prophylaxis during the window period, usually directly observed therapy with isoniazid. Hepatotoxicity and tuberculosis disease did not develop in any child. TST conversion occurred in 37 (4.9%) children and was associated with the index patient being the child’s parent (odds ratio 3.2, 95% CI 1.2–8.2). TST conversion was not associated with sputum smear results, culture positivity, or cohabitation. Thresholds for initiation of window prophylaxis in exposed young children should be low given the safety of medication and difficulties with risk stratification.

Keywords

• directly-observed therapy
• isoniazid
• tuberculin skin test
• tuberculosis exposure
• window prophylaxis
• tuberculosis