High completion of isoniazid preventive therapy among HIV-infected children and adults in Kinshasa, Democratic Republic of Congo

Yotebieng, Marcel; Edmonds, Andrew; Lelo, Patricia; Wenzi, Landry Kipula; Papy, Ndjibu,; Lusiama, Jean; Kabuayi, Jean Pierre; Behets, Frieda

doi:10.1097/qad.0000000000000791

Cited by 20 publications

(18 citation statements)

References 14 publications

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“…Though the majority of patients in our study completed IPT, there remains room for improvement especially among younger patients and those reporting side effects. Although prior research has shown that patients on ART are more likely to adhere to IPT, 8,9 our findings suggest that in a sample of highly ART adherent patients in differentiated care, barriers to IPT completion persist.…”

Section: Discussioncontrasting

confidence: 68%

“…In the Democratic Republic of Congo and Ethiopia IPT completion among patients on ART was 89% 8 and 86%, 9 respectively. One possible explanation for this difference is that some patients in differentiated care may perceive the costs associated with increased visit frequency for IPT to outweigh the benefits of IPT, and they in turn may prioritize collecting ART over IPT refills.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Isoniazid Preventive Therapy Completion in the Era of Differentiated HIV Care

Tram¹,

Mwangwa²,

Atukunda³

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 98%

Isoniazid Preventive Therapy Completion in the Era of Differentiated HIV Care

Tram¹,

Mwangwa²,

Atukunda³

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…WHO recommends the completion of at least six months IPT for the successful prevention of active tuberculosis among PLHIV (4,10). Globally, six-month IPT completion has been reported to range from 39-99% (28)(29)(30)(31)(32)(33)(34)(35)(36)(37), and in Tanzania studies reported 65%-98% of those who initiated IPT, completed the six month treatment course (6,20,(38)(39)(40). Most epidemiological studies have shown that IPT completion reduces the risks of mortality among PLHIV (8,26,41)…”

Section: Introductionmentioning

confidence: 99%

Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

Robert

Todd²,

Ngowi

et al. 2020

Preprint

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Background: Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least six months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor completion of IPT, as a suboptimal dose may not protect PLHIV from TB infection. This study determined IPT completion and its determinants among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania. Methods: A Cross-sectional analytical study was conducted using secondary analysis of routine data from 58 care and treatment clinics in Dar es Salaam region. The study recruited clients who screened negative for TB symptoms and initiated IPT between January 2013 and June 2017. Modified Poisson regression model with robust standard errors were used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account the health facility random effects in order to estimate independent factors associated with IPT completion. Results : A total of 29,382 clients were initiated on IPT, with 21,808 (74%) female. Overall 17,092 (58%) completed IPT, increasing from 42% (773/1,857) in year 2013 to 76% (2,929/3,856) in 2017. Multilevel multivariable model accounting for health facility as clusters, found that clients with CD4 counts between 100 to 349 cells/ had 3% lower prevalence of IPT completion as compared to those with 100 cells/ (PR:0.97: 95%CI:0.94-1.01). Patients who were not on ART had 46% lower IPT completion compared to those were on ART (PR: 0.54: 95%CI: 0.45-0.64). There was lower IPT completion among clients who transferred to another clinic compared to those attended the same clinic where they were initiated IPT (PR: 0.63: 95% CI (0.54-0.74). Conclusion: IPT completion is low at care and treatment clinics although it increased over time. Lower IPT completion was seen in PLHIV with CD4 counts between 100 to 349 cells/ , those who transferred to other clinics and those not on ART. Thus it indicates the need for better IPT interventions with greater support PLHIV in those groups.

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“…Our IPT completion and adherence rates were similar to reports from other African studies with findings ranging from of 78–98.9 %. 12, 13, 17, 19, 31–33 We attributed high IPT adherence to the well-resourced clinical research setting, structured adherence support programme and needing to come in for ART. There is strong evidence supporting combining ART use with IPT to significantly improve IPT adherence.…”

Section: Discussionmentioning

confidence: 99%

Implementing isoniazid preventive therapy in a tuberculosis treatment-experienced cohort on ART

Maharaj

Gengiah

Yende‐Zuma

et al. 2017

int j tuberc lung dis

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SETTING Urban clinical research site in Durban, South Africa OBJECTIVE To describe the outcomes associated with implementation of isoniazid preventive therapy (IPT) in a cohort of TB treatment experienced HIV infected patients on antiretroviral therapy (ART). DESIGN We conducted a secondary analysis of data collected between October 2009 and October 2013 from patients enrolled in a prospective cohort study conducted in Durban, South Africa. RESULTS There were 402 patients enrolled in the parent study. Of these 344 (85.6%) were eligible to receive IPT and of whom 212 (61.6%) initiated IPT. Among those that initiated IPT, 184 (86.8%) completed the six month course, 24 (11.3%) permanently discontinued IPT and of these, 3.8% discontinued due to side effects. More women (n=130; 61.3%) initiated IPT (p=0.001) than men. Overall median adherence to IPT was 97.6% (IQR: 94.2 – 99.4). There were 22 cases of incident TB in this cohort: 13 occurred prior to IPT and nine after IPT (incidence rate ratio 0.67; 95% CI 0.29–1.58; p=0.362). CONCLUSIONS IPT implementation amongst ART and TB treatment experienced patients was well tolerated with good completion rates and fewer TB cases diagnosed after IPT exposure.

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High completion of isoniazid preventive therapy among HIV-infected children and adults in Kinshasa, Democratic Republic of Congo

Cited by 20 publications

References 14 publications

Isoniazid Preventive Therapy Completion in the Era of Differentiated HIV Care

Isoniazid Preventive Therapy Completion in the Era of Differentiated HIV Care

Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

Implementing isoniazid preventive therapy in a tuberculosis treatment-experienced cohort on ART

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