Coverage of isoniazid preventive therapy among people living with HIV; A retrospective cohort study in Tanzania (2012-2016).
Isoniazid preventive therapy
PLHIV and tuberculosis
Tanzania
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
10
09
2020
revised:
26
11
2020
accepted:
26
11
2020
pubmed:
5
12
2020
medline:
5
5
2021
entrez:
4
12
2020
Statut:
ppublish
Résumé
Isoniazid Preventive Therapy (IPT) is a proven public health tool to reduce Tuberculosis (TB) among people living with HIV. However, its implementation in most countries is suboptimal. This retrospective study was conducted to determine the coverage and factors associated with IPT initiation to inform program scale up and improve quality of service in Tanzania and elsewhere. Retrospective cohort study design involving HIV clinics in Dar es Salaam, Iringa and Njombe regions from January 2012 to December 2016. A total of 171,743 PLHIV were in the cohort from 2012 to 2016. Of these, 166,709 were involved in the analysis. Of those analyzed, 23,970 (14.38%) were ever initiated on IPT. Female sex (aOR = 1.72, 95% CI: 1.13, P < 0.001), obesity (aOR = 1.29, 95% CI:1.20-1.39, P < 0.001), WHO clinical stage II (aOR = 1.48, 95% CI: 1.42-1.55, P < 0.001), enrolment in hospitals (aOR = 1.98, 95% CI: 1.89-2.06, P < 0.001), enrolment in Njombe region (aOR = 1.25: 95% CI: 1.18-1.33, P < 0.001) and enrolment in public health facilities (aOR = 1.93: 95% CI: 1.82-2.04, P < 0.001) were associated with increased IPT uptake. Being on ART (aOR = 0.67, 95% CI: 0.65-0.70, P < 0.001) and severe nutritional status (aOR = 0.72, 95% CI: 0.60-0.88, P < 0.001) were associated with decreased IPT initiation. Our study documented low IPT initiation in the study area as well as documented factors which enable IPT initiation and those which impair IPT initiation. Strategies are needed to work on barriers and sustain enabling factors to improve IPT coverage.
Sections du résumé
BACKGROUND
BACKGROUND
Isoniazid Preventive Therapy (IPT) is a proven public health tool to reduce Tuberculosis (TB) among people living with HIV. However, its implementation in most countries is suboptimal. This retrospective study was conducted to determine the coverage and factors associated with IPT initiation to inform program scale up and improve quality of service in Tanzania and elsewhere.
METHODS
METHODS
Retrospective cohort study design involving HIV clinics in Dar es Salaam, Iringa and Njombe regions from January 2012 to December 2016.
RESULTS
RESULTS
A total of 171,743 PLHIV were in the cohort from 2012 to 2016. Of these, 166,709 were involved in the analysis. Of those analyzed, 23,970 (14.38%) were ever initiated on IPT. Female sex (aOR = 1.72, 95% CI: 1.13, P < 0.001), obesity (aOR = 1.29, 95% CI:1.20-1.39, P < 0.001), WHO clinical stage II (aOR = 1.48, 95% CI: 1.42-1.55, P < 0.001), enrolment in hospitals (aOR = 1.98, 95% CI: 1.89-2.06, P < 0.001), enrolment in Njombe region (aOR = 1.25: 95% CI: 1.18-1.33, P < 0.001) and enrolment in public health facilities (aOR = 1.93: 95% CI: 1.82-2.04, P < 0.001) were associated with increased IPT uptake. Being on ART (aOR = 0.67, 95% CI: 0.65-0.70, P < 0.001) and severe nutritional status (aOR = 0.72, 95% CI: 0.60-0.88, P < 0.001) were associated with decreased IPT initiation.
CONCLUSIONS
CONCLUSIONS
Our study documented low IPT initiation in the study area as well as documented factors which enable IPT initiation and those which impair IPT initiation. Strategies are needed to work on barriers and sustain enabling factors to improve IPT coverage.
Identifiants
pubmed: 33276111
pii: S1201-9712(20)32507-8
doi: 10.1016/j.ijid.2020.11.192
pmc: PMC7862080
pii:
doi:
Substances chimiques
Antitubercular Agents
0
Isoniazid
V83O1VOZ8L
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
562-567Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.