Factors associated with initiation of TB preventive therapy.

<sec><title>BACKGROUND</title>This study aimed to explore the factors associated with TB preventive therapy (TPT) uptake among household contacts of TB patients in the southern region of Bangladesh, a high-TB-burden country.</sec><sec><title>METHODS</title>This cross-sectional study was conducted among household contacts of pulmonary TB cases who were eligible for TPT in Khulna District, Bangladesh, between September and October 2023. A total of 378 participants were selected randomly from six organisations providing Directly Observed Therapy Short-course (DOTS) services, using DOTS centre record books. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire digitised in Kobo Toolbox.</sec><sec><title>RESULTS</title>Among the participants, 64.8% had initiated TPT. Age above 16 years (adjusted odds ratio [aOR]: 3.61, 95% confidence interval [CI]: 1.88-7.02), education level of SSC and above (aOR: 4.27, 95% CI: 2.36-7.87), knowledge about TPT (aOR: 2.55, 95% CI: 1.27-5.13), and receiving TPT counselling (aOR: 16.3, 95% CI: 4.03-112.0) emerged as strong positive predictors of TPT uptake. Urban residence showed lower odds (aOR: 0.25, 95% CI: 0.09-0.59) compared to semi-urban areas. The primary barriers to TPT uptake were fear of side effects (40.6%), drug unavailability (36.1%), and lack of interest (29.3%).</sec><sec><title>CONCLUSION</title>Successful TPT implementation requires strengthening health communication, ensuring drug availability, and addressing socio-economic barriers, particularly in urban areas.</sec>.