Completion of tuberculosis preventive treatment in children and adolescents aged 0 to 15 in Brazil: analysis of a retrospective cohort

Tuberculosis preventive treatment (TPT) is essential for preventing tuberculosis among children and adolescents, but treatment completion remains a major challenge worldwide. We analyzed factors associated with TPT completion and treatment outcomes among children and adolescents aged 0–15 years in Brazil and assessed the impact of the introduction of the 3HP regimen on TPT completion in this population. TPT notifications of a cohort of children and young adolescents (0 to 15 years) in the national TB database from 2018 to 2023 were analysed. A robust variance Poisson regression model verified factors associated with TPT completion. Multivariate analysis results were interpreted as relative risk (RR) with 95% confidence intervals (95% CI). Among 31,121 notified cases, 24,903 had complete outcome information. Modestly higher TPT completion was observed among children aged 5–9 years (RR 1.02; 95% CI 1.01–1.04), and adolescents between the ages of 10 and 15 (RR 1.03; 95% CI 1.02–1.05), among those of white skin color (RR 1.02; 95% CI 1.01–1.03), vaccinated with BCG (RR 1.05; 95% CI 1.02–1.08), using immunosuppressive therapy (RR 1.07; 95% CI 1.03–1.19), or in shorter TPT schemes of 4 months of rifampicin (RR 1.10; 95% CI 1.08–1.12) and 3 months of isoniazid plus rifapentine (RR 1.13; 95% CI 1.12–1.15). Although the observed associations were modest, the use of shorter TPT regimens and strategies to improve adherence among children younger than 5 years may enhance TPT completion in Brazil.