scholarly journals The effect of isoniazid preventive therapy on incidence of tuberculosis among HIV-infected clients under pre-ART care, Jimma, Ethiopia: a retrospective cohort study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Lelisa Fekadu Assebe ◽  
Hailemariam Lemma Reda ◽  
Alem Desta Wubeneh ◽  
Wondwossen Terefe Lerebo ◽  
Saba Maria Lambert
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy

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 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.

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 Factors associated with mortality in persons co-infected with tuberculosis and HIV in Suriname: a retrospective cohort study

2019 ◽  
Vol 43 ◽  
pp. 1
Author(s):  
Deborah Stijnberg ◽  
Eric Commiesie ◽  
Diana Marín ◽  
Ward Schrooten ◽  
Freddy Perez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Preventive Therapy ◽  
Hiv Treatment ◽  
Rank Test ◽  
Factors Associated ◽  
Risk Of Death ◽  
Directly Observed Treatment ◽  
Using Data

Objective. To identify socio-demographic and clinical factors associated with mortality among persons with tuberculosis (TB) and TB/HIV co-infection in Suriname. Methods. This was a retrospective cohort study using data from the national TB and HIV databases for 2010 – 2015. The survival probability of TB and TB/HIV co-infected patients was analyzed using the Kaplan-Meier estimates and the log-rank test. A Cox proportional hazard model was applied. Results. The study showed that HIV-seropositivity (aHR: 2.08, 95%CI: 1.48 – 2.92) and older age (aHR: 5.84, 95%CI: 3.00 – 11.4) are statistically associated with higher mortality. For the TB/HIV co-infected patients, TB treatment (aHR: 0.43, 95%CI: 0.35 – 0.53) reduces the risk of death. Similarly, HIV treatment started within 56 days (aHR: 0.15, 95%CI: 0.12 – 0.19) and delayed (aHR: 0.25, 95%CI: 0.13 – 0.47) result in less hazard for mortality; Directly-Observed Treatment (aOR: 0.16, 95%CI: 0.09 – 0.29) further reduces the risk. Conclusions. The Ministry of Health of Suriname should develop strategies for early case-finding in key populations, such as for HIV and TB in men 60 years of age and older. Implementation of Isoniazid Preventive Therapy for HIV should be pursued. Scaling up TB and HIV treatment, preferably through supervision, are essential to reducing the TB/HIV mortality.

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