scholarly journals Assessing the Impact of Isoniazid Preventive Therapy (IPT) on Tuberculosis Incidence and Predictors of Tuberculosis among Adult Patients Enrolled on ART in Nekemte Town, Western Ethiopia: A Retrospective Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Gemechu Tiruneh ◽  
Alemayehu Getahun ◽  
Emiru Adeba
Keyword(s):  
Cohort Study ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Clinical Staging ◽  
Tuberculosis Incidence ◽  
Western Ethiopia

Background. Isoniazid preventive therapy is a prophylactic treatment used in the prevention of active tuberculosis. It is known to be most effective in preventing tuberculosis in patients with positive tuberculin skin test. Methods. A retrospective cohort study centering on two institutions in Nekemte town, Western Ethiopia, was employed. Secondary data of 600 medical records were analyzed by Cox regression. Result. Tuberculosis incidence among the Isoniazid treated group was 1.98 per 100 person-years and 4.52 per 100 person-years in the untreated group. CD4 cell count, clinical staging, body mass index (BMI), not using cotrimoxazole, body weight, and functional status were significant predictors of tuberculosis risk. Isoniazid preventive therapy use was associated with 55% reduction of tuberculosis incidence. Conclusion. Isoniazid preventive therapy use was associated with significant reduction in tuberculosis incidence, even in the absence of Tuberculin Skin Test (TST). Therefore, isoniazid preventive therapy (IPT) coverage should be used more widely, with special emphasis given to patients at higher risk of tuberculosis. The study shows that the absence of TST testing should not be a limitation.

scholarly journals Evaluation of routine Isoniazid Preventive Therapy among People Living with HIV for reducing Tuberculosis; a retrospective cohort study in Tanzania (2012-2016)

2020 ◽  
Author(s):  
Werner Maokola ◽  
Bernard Ngowi ◽  
Lovett Lawson ◽  
Michael Mahande ◽  
Jim Todd ◽  
...  
Keyword(s):  
Cohort Study ◽  
Functional Status ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Scale Up ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Living With Hiv

Abstract Background: Isoniazid Preventive Therapy (IPT) reduced Tuberculosis (TB) among People Living with HIV (PLHIV). Despite this, uptake has been reported to be sub-optimal . We describe characteristics of visits in which PLHIV were screened TB negative (as the main source for IPT initiation), determine characteristics of visits in which PLHIV were initiated on IPT as well as determined factors associated with IPT initiation to inform program scale up and improve quality of service.Methods : Retrospective cohort study design which involved PLHIV enrolled into care and treatment clinics in Dar es Salaam, Iringa and Njombe regions from January 2012 to December 2016. The study aimed at evaluating implementation of IPT among PLHIV. Data analysis was conducted using STATA.Results: A total 173,746 were enrolled in CTC in the 3 regions during the period of follow up and made a total of 2,638,876 visits. Of the eligible visits, only 24,429 (1.26%) were initiated on IPT. In multivariate analysis, 50 years and more (aOR=3.42, 95% CI: 3.07-3.82, P<0.01), bedridden functional status individuals with bedridden functional status (aOR=4.56, 95% CI:2.45-8.49, P<0.01) and WHO clinical stage II had higher odds of IPT initiation (aOR=1.18, 95% CI:1.13-1.23, P<0.01). Furthermore, enrolment in 2016 (aOR=2.92, 95% CI:2.79-3.06, P<0.01), enrolment in hospitals (aOR=1.84, 95% CI:1.77-1.90, P<0.01), enrolment in public health facilities (aOR=1.82, 95% CI: 1.75-1.90, P<0.01) and been on care for more than one year (aOR=6.77, 95% CI: 5.25-8.73, P<0.000) were also more likely to be initiated on IPT. Enrollment in Iringa (aOR=0.44, 95% CI: 0.41-0.47, P<0.01) and good adherence (aOR=0.56, 95% CI 0.47-0.67, P<0.01) was less likely to be initiated on IPT.Conclusions: Our study documented low IPT initiation proportion among those who were enrolled in HIV care and eligible in the 3 regions during the study period. Variations in IPT initiation among regions signals different dynamics affecting IPT uptake in different regions and hence customized approaches in quality improvement. Implementation research is needed to understand health system as well as cultural barriers in the uptake of IPT intervention.

scholarly journals Live attenuated varicella vaccine may affect the sensitivity of tuberculin skin test

2020 ◽  
Author(s):  
Tingting Li ◽  
Kai Zhu ◽  
Yujie Kuang ◽  
Hongbo Qu ◽  
Qi Zhang ◽  
...  
Keyword(s):  
High School ◽  
Cohort Study ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Varicella Vaccine ◽  
Varicella Vaccination ◽  
Mean Diameter ◽  
The Mean

Abstract Background: Tuberculin skin test (TST) has been the most commonly used test for diagnosis of tuberculosis (TB) infection in China for many years, because of well-established algorithms for test interpretation and a good cost-effectiveness. To our knowledge , there is no report or guideline on the influence of varicella vaccine on the sensitivity of TST in China. This paper aims to explore the effect of live attenuated varicella vaccine on the sensitivity of TST.Methods: A retrospective cohort study was carried out in a high school in Wuxi, Jiangsu province in 2020. TST and emergency varicella vaccine were administered to students in grade one of the high school which had both TB and varicella cases. The mean diameter of induration of TST were compared between 73d before varicella vaccine, 9d and 120d after varicella vaccine respectively. The retrospective cohort study was used to analyze the effect of live attenuated varicella vaccine on TST.Results: There were 45 students in the class of the high school had three TST, and 22 of them were vaccinated varicella. After 9 days of varicella vaccination, the mean diameter of induration was significantly smaller than that before the vaccination of 73 days and after the vaccination of 120 days (p<0.05), respectively. Moreover, there is no significant different for mean diameter of induration between the TST before the vaccination of 73 days and after the vaccination of 120 days (p=0.551). The retrospective cohort study analysis indicated that 9 days after varicella vaccination ( RR, 6.071, 95%CI, 1.667～22.116, P=0.007 ) was associated with the changed mean induration diameter of TST. After vaccination of 120 days ( RR, 3.474, 95%CI, 0.333～36.240, P=0.346 ) was not associated with the changed mean induration of TST.Conclusions: Live attenuated varicella vaccine may temporarily affect the sensitivity of tuberculin skin test.

scholarly journals Initiation and completion rates of isoniazid preventive therapy among people living with HIV in Far-Western Region of Nepal: a retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e029058 ◽  
Author(s):  
Govinda Prasad Dhungana ◽  
Pruthu Thekkur ◽  
Palanivel Chinnakali ◽  
Usha Bhatta ◽  
Basudev Pandey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Western Region ◽  
Completion Rates ◽  
Living With Hiv

ObjectivesIsoniazid preventive therapy (IPT), for people living with HIV (PLHIV) is the proven and recommended intervention to avert tuberculosis (TB). In 2015, Nepal implemented 6 months of IPT for all PLHIV registered for HIV care in antiretroviral therapy (ART) centres. After programmatic implementation, there has been no systematic assessment of IPT initiation and completion rates among PLHIV. We aimed to assess IPT initiation and completion rates in the Far-Western Region (FWR) of Nepal.DesignWe conducted a retrospective cohort study using secondary data extracted from registers maintained at ART centres.SettingAll 11 ART centres in the FWR of Nepal.ParticipantsAll PLHIV registered for care between January 2016 and December 2017 in 11 ART centres.Primary outcome measuresIPT initiation and completion rates were summarised as percentages with 95% CI. Independent association between patient characteristics and non-initiation of IPT was assessed using cluster-adjusted generalised linear model (log binomial regression) and adjusted relative risk (RR) with 95% CI was calculated.ResultOf the 492 PLHIV included, 477 (97.0%) did not have active TB at registration. Among 477 without active TB, 141 (29.8%, 95% CI 25.7% to 34.1%) had been initiated on IPT and 85 (17.8%) were initiated within 3 months of registration. Of 141 initiated on IPT, 133 (94.3%, 95% CI 89.1% to 97.5%) had completed 6 months of IPT. Being more than 60 years of age (RR-1.3, 95% CI 1.1 to 1.7), migrant worker (RR-1.3, 95% CI 1.1 to 1.4) and not being initiated on ART (RR-1.4, 95% CI 1.1 to 1.8) were significantly associated with IPT initiation.ConclusionsIn FWR of Nepal, three out of 10 eligible PLHIV had received IPT. Among those who have received IPT, the completion rate was good. The HIV care programme needs to explore the potential reasons for this low coverage and take context specific corrective action to fix this gap.

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