scholarly journals Integrated and patient-selected care facilitates completion of isoniazid preventive therapy in Eswatini

2019 ◽  
Vol 9 (4) ◽  
pp. 153-158
Author(s):  
L. V. Adams ◽  
T. S. B. Maseko ◽  
E. A. Talbot ◽  
S. W. Grande ◽  
M. M. Mkhontfo ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Preventive Therapy ◽  
High Rate ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
Critical Factors ◽  
Cross Sectional ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Living With Hiv

Setting: Five human immunodeficiency virus (HIV) care facilities in Eswatini.Objective: To identify critical factors that enabled persons living with HIV to successfully complete a 6-month course of isoniazid preventive therapy (IPT) provided through a choice of facility-based or community-based delivery, coordinated with antiretroviral therapy (ART) refills.Design: This was a mixed methods, retrospective cross-sectional study.Results: Between June and October 2017, we interviewed 150 participants who had completed IPT in the previous year. Fourteen participants did not recall being offered a choice, and were excluded from the analysis. Of the remaining 136, 56.6% were female and 64.7% chose facility-based care; the median age was 42.5 years. Most participants reported that having a choice was important to their treatment completion (87.7%) and that linking IPT and ART refills facilitated undergoing IPT (98.5%). Participants were knowledgeable about the benefits of IPT and valued the education received from their providers. Participants also reported a high rate of IPT disclosure (95%) to friends and family members.Conclusion: Offering patients a choice of IPT delivery, linking IPT with ART refills, emphasizing patient education and engagement with healthcare workers, and supporting disclosure of IPT are critical factors to enabling IPT completion. These interventions should be incorporated throughout Eswatini and in similar high tuberculosis and HIV burden settings.

scholarly journals Isoniazid Preventive Therapy Adherence and Associated Factors among HIV Positive Patients in Addis Ababa, Ethiopia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Melaku Berhe ◽  
Meaza Demissie ◽  
Gezahegn Tesfaye
Keyword(s):  
Associated Factors ◽  
Addis Ababa ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Health Centers ◽  
Isoniazid Preventive Therapy ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Living With Hiv

Tuberculosis coinfected with HIV constitutes a large proportion of patients in Ethiopia. Isoniazid preventive therapy (IPT) is recommended for the treatment of latent tuberculosis infection. However, the level of IPT adherence and associated factors among people living with HIV (PLHIV) have not been well explored. This study aimed to assess adherence to IPT and associated factors among PLHIV in Addis Ababa. Facility based cross-sectional study was conducted. The study was conducted in 10 health centers and 2 hospitals. Patients were consecutively recruited till the required sample size was obtained. From 406 PLHIV approached, a total of 381 patients on IPT were interviewed. Data were entered and analyzed using Epi-Info version 3.5 and SPSS version 16. The level of adherence to IPT was 89.5%. Patients who have taken isoniazid for ≥5 months were more likely to be adherent than those who took it for 1-2 months [AOR (95%CI) = 5.09 (1.41–18.36)]. Patients whose friends decide for them to start IPT were less likely to be adherent than others [AOR (95%CI) = 0.10 (0.01–0.82)]. The level of adherence to IPT in PLHIV was high. Counseling of patients who are in their first two months of therapy should be more strengthened. Strong Information Education Communication is essential to further enhance adherence.

scholarly journals Isoniazid preventive therapy utilization rate and associated factors in adult HIV/AIDS patients in Jimma University Specialized Hospital ART clinic, Oromia Region, Ethiopia: A cross-sectional study.

2019 ◽  
Author(s):  
Gudeta Imana Jaleta ◽  
Vinodhini Rajamanickam ◽  
Kifle Woldemichael
Keyword(s):  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Hiv Care ◽  
Utilization Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Depth Interviews ◽  
Jimma University

Abstract Background: Tuberculosis (TB) is the most frequent life-threatening infection and a common cause of death for people living with HIV (PLHIV). The influence of TB and HIV infection has enhanced the magnitude of both epidemics. Several clinical interventions recommended early diagnosis in PLHIV and treating latent TB infection (LTBI) with Isoniazid preventive therapy (IPT) along with antiretroviral therapy (ART). IPT is one of the key interventions recommended by the world health organization (WHO) for the prevention of TB in patients infected with HIV. Hence, this study aimed to determine IPT utilization rate among adult HIV infected patients enrolled in HIV care and qualitative analysis, which explore the factors that influence IPT use among PLHIV under follow-up, Health care providers (HCPs) and TB/HIV coordinators working in Jimma University Specialized Hospital (JUSH) ART clinic. Methods: An Institution based mixed cross-sectional study was conducted in JUSH ART clinic. Adult HIV infected patients were enrolled by a systematic sampling technique from the registered medical records of JUSH HIV care. PLHIV who were on follow-up and eligible for IPT during the study period, permanent HCPs and TB/HIV coordinators working in ART clinic were included in the qualitative investigation using semi-structured questioners and in-depth interviews. All statistical analysis was compiled by Epi data 3.1 and SPSS 20. Results: Demographic and clinical factors are not significantly associated with IPT use but ethnicity (P≤ 0.02**) was highly significant with IPT use in logistic regression model. Overall, 59.2% of the patients have been prescribed and taken at least one-month course of IPT. The results of in-depth interviews are grouped into three core categories as patient perceptions, HCPs and TB/HIV coordinator perspectives. Discussion and conclusion: PLHIV, HCPs and TB/HIV coordinators suggested their overall response as periodic counseling for target groups, educating the benefits of IPT and increasing public awareness on TB prophylaxis in PLHIV will increase the acceptance and implementation of IPT in large scale. Higher attention should be provided in linking all HIV patients to the nearest health facilities for receiving free service packages and medical care. Key words: IPT, TB /HIV, PLHIV, ART, INH prophylaxis

Has Diarrhea Ceased to be a Concern in Persons Living With HIV? Results From a Cross-sectional Study

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Robin L. Hardwicke ◽  
Estefania Guthrie ◽  
Han-Yang Chen ◽  
Richard M. Grimes
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Persons Living With Hiv ◽  
Living With Hiv

scholarly journals Impact of Isoniazid Preventive Therapy on Tuberculosis incidence among people living with HIV: A secondary data analysis using Inverse Probability Weighting of individuals attending HIV care and treatment clinics in Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254082
Author(s):  
Werner M. Maokola ◽  
Bernard J. Ngowi ◽  
Michael J. Mahande ◽  
Jim Todd ◽  
Masanja Robert ◽  
...  
Keyword(s):  
Observational Studies ◽  
Cox Regression ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Clinical Settings ◽  
Inverse Probability ◽  
Care And Treatment ◽  
Living With Hiv

Background Information on how well Isoniazid Preventive Therapy (IPT) works on reducing TB incidence among people living with HIV (PLHIV) in routine settings using robust statistical methods to establish causality in observational studies is scarce. Objectives To evaluate the effectiveness of IPT in routine clinical settings by comparing TB incidence between IPT and non-IPT groups. Methods We used data from PLHIV enrolled in 315 HIV care and treatment clinic from January 2012 to December 2016. We used Inverse Probability of Treatment Weighting to adjust for the probability of receiving IPT; balancing the baseline covariates between IPT and non-IPT groups. The effectiveness of IPT on TB incidence was estimated using Cox regression using the weighted sample. Results Of 171,743 PLHIV enrolled in the clinics over the five years, 10,326 (6.01%) were excluded leaving 161,417 available for the analysis. Of the 24,800 who received IPT, 1.00% developed TB disease whereas of the 136,617 who never received IPT 6,085 (4.98%) developed TB disease. In 278,545.90 person-years of follow up, a total 7,052 new TB cases were diagnosed. Using the weighted sample, the overall TB incidence was 11.57 (95% CI: 11.09–12.07) per 1,000 person-years. The TB incidence among PLHIV who received IPT was 10.49 (95% CI: 9.11–12.15) per 1,000 person-years and 12.00 (95% CI: 11.69–12.33) per 1,000 person-years in those who never received IPT. After adjusting for other covariates there was 52% lower risk of developing TB disease among those who received IPT compared to those who never received IPT: aHR = 0.48 (95% CI: 0.40–0.58, P<0.001). Conclusion IPT reduced TB incidence by 52% in PLHIV attending routine CTC in Tanzania. IPTW adjusted the groups for imbalances in the covariates associated with receiving IPT to achieve comparable groups of IPT and non-IPT. This study has added evidence on the effectiveness of IPT in routine clinical settings and on the use of IPTW to determine impact of interventions in observational studies.

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 Successful implementation of isoniazid preventive therapy at a pediatric HIV clinic in Tanzania

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Olivia F. Hunter ◽  
Furaha Kyesi ◽  
Amrit Kaur Ahluwalia ◽  
Zeinabou Niamé Daffé ◽  
Patricia Munseri ◽  
...  
Keyword(s):  
Treatment Completion ◽  
Preventive Therapy ◽  
Pediatric Hiv ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
Successful Implementation ◽  
Completion Rates ◽  
Community Based ◽  
Symptom Screening ◽  
Living With Hiv

Abstract Background In accordance with international guidance for tuberculosis (TB) prevention, the Tanzanian Ministry of Health recommends isoniazid preventive therapy (IPT) for children aged 12 months and older who are living with HIV. Concerns about tolerability, adherence, and potential mistreatment of undiagnosed TB with monotherapy have limited uptake of IPT globally, especially among children, in whom diagnostic confirmation is challenging. We assessed IPT implementation and adherence at a pediatric HIV clinic in Tanzania. Methods In this prospective cohort study, eligible children living with HIV aged 1–15 years receiving care at the DarDar Pediatric Program in Dar es Salaam who screened negative for TB disease were offered a 6-month regimen of daily isoniazid. Patients could choose to receive IPT via facility- or community-based care. Parents/caregivers and children provided informed consent and verbal assent respectively. Isoniazid was dispensed with the child’s antiretroviral therapy every 1–3 months. IPT adherence and treatment completion was determined by pill counts, appointment attendance, and self-report. Patients underwent TB symptom screening at every visit. Results We enrolled 66 children between July and December 2017. No patients/caregivers declined IPT. Most participants were female (n = 43, 65.1%) and the median age was 11 years (interquartile range [IQR] 8, 13). 63 (95.5%) participants chose the facility-based model; due to the small number of participants who chose the community-based model, valid comparisons between the two groups could not be made. Forty-nine participants (74.2%) completed IPT within 10 months. Among the remaining 17, 11 had IPT discontinued by their provider due to adverse drug reactions, 5 lacked documentation of completion, and 1 had unknown outcomes due to missing paperwork. Of those who completed IPT, the average monthly adherence was 98.0%. None of the participants were diagnosed with TB while taking IPT or during a median of 4 months of follow-up. Conclusions High adherence and treatment completion rates can be achieved when IPT is integrated into routine, self-selected facility-based pediatric HIV care. Improved record-keeping may yield even higher completion rates. IPT was well tolerated and no cases of TB were detected. IPT for children living with HIV is feasible and should be implemented throughout Tanzania.

scholarly journals Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries

10.2196/13741 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13741
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
West African ◽  
Hiv Care ◽  
People Living With Hiv ◽  
African Countries ◽  
Cross Sectional ◽  
Factors Associated ◽  
Living With Hiv

Background The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. Objective The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. Methods A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. Results A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01). Conclusions The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

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