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

Maokola, Werner; Ngowi, Bernard; Mahande, Michael Johnson; Todd, Jim; Robert, Masanja; Msuya, Sia E.

doi:10.1371/journal.pone.0254082

Cited by 5 publications

(4 citation statements)

References 47 publications

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“…1,7 Preventative therapies, including 6-9 months of isoniazid and more recently tested shorter courses of multiple drugs, like 3 months of rifapentine and isoniazid (3HP), have been successful in reducing the short-term risk of progression to ATB in PLWH. [8][9][10] The impact of TB prevention therapies has been limited by the difficulty of diagnostic testing for LTBI. The tuberculin skin test (TST) uses purified protein derivative (PPD) from Mtb and has significant rates of cross-reactivity with the M. bovis BCG strain used to vaccinate infants in TB endemic countries.…”

Section: Introductionmentioning

confidence: 99%

Discrepancy between Mtb-specific IFN-γ and IgG responses in HIV-positive people with low CD4 counts

Mthembu¹,

Bowman²,

Davies³

et al. 2023

eBioMedicine

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Section: Introductionmentioning

confidence: 99%

Discrepancy between Mtb-specific IFN-γ and IgG responses in HIV-positive people with low CD4 counts

Mthembu¹,

Bowman²,

Davies³

et al. 2023

eBioMedicine

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“…This difference might be attributed to the different study design and sampling techniques used. Other studies reported similar findings of lower incidence rates among PLHIV that completed IPT therapy than those who were not IPT therapy 17 – 19 .…”

Section: Discussionmentioning

confidence: 52%

“…A number of studies have reported that IPT significantly reduces incidence of TB among PLHIV after completion of the 6 month period of treatment 17 – 19 . This study recorded a TB prevalence of 5.8% among PLHIV who had completed the 6 months period of IPT treatment, which is lower than 8.1% and 9.0% reported respectively in studies conducted in Ethiopia 13 , 14 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of tuberculosis among HIV patients who completed isoniazid preventive therapy (IPT) at Reach out Mbuya community health initiative

Sekayi,

Namyalo,

Namayanja

et al. 2023

Sci Rep

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Tuberculosis (TB) continues to be the leading cause of morbidity and mortality among human immunodeficiency virus (HIV) infected individuals in Sub Saharan Africa, including Uganda. Isoniazid prophylaxis therapy (IPT) is a major public health intervention to limit tuberculosis disease among people living with HIV. However, there is limited information about the influence of IPT on TB disease incidence and its associated risk factors among HIV positive patients in Uganda especially at Reach out-Mbuya community health initiative hence the study. A cross sectional study was conducted among HIV positive adult patients who completed a 6-months long daily treatment of Isoniazid preventive therapy. Sputum samples and urine samples were collected and analysed using Gene Xpert and lateral flow urine Lipoarabinomannan (LF-LAM) tests respectively for presence of Tuberculosis disease. Data analysis was performed using STATA (version 14). Bivariate and multivariate logistic regression were performed to assess the risk factors associated with tuberculosis among the study population and significance estimated at 95% confidence level. A total of 103 HIV positive adults was studied. The mean age of the participants was 42.1 (10.5) and median age was 43 (IQR = 16). The prevalence of tuberculosis disease among HIV positive adult patients who completed Isoniazid preventive therapy was 5.8% (6/103). Counselling, the only significant factor, reduced the likelihood of occurrence of TB disease among HIV patients on IPT treatment (aOR:0.028, P-value < 0.001). A low prevalence of TB disease was observed among HIV patients on IPT treatment. Counselling is a protective factor of TB disease among HIV patients on IPT treatment.

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“…Tanzania uses isoniazid preventive treatment (IPT) for prevention of active TB disease among PLHIV since 2010 (7). The IPT involves the use of self-administered isoniazid daily for 6 to 9 months (8,9).…”

Section: Introductionmentioning

confidence: 99%

Optimizing delivery strategies for 3HP TB preventive treatment in Tanzania: A qualitative study on acceptability of family approach in HIV care and treatment centers

Pamba,

Sanga,

Mlalama

et al. 2024

Preprint

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IntroductionTanzania rolled-out a 12-dose, weekly regimen of isoniazid plus rifapentine (3HP) TB preventive treatment in January, 2024. Although 3HP completion rate is generally ≥ 80%, variations exist depending on type of delivery strategy and programmatic setting. Prior to the roll-out, a mixed methods study was conducted to assess whether a family approach involving family member support, SMS reminders and three health education sessions, was acceptable and optimized 3HP uptake and completion. This paper describes acceptability of the family approach among people living with HIV (PLHIV), treatment supporters (TS) and community health workers (CHWs).MethodsThis was a qualitative descriptive study in 12 HIV care and treatment centers across six administrative regions. We purposively sampled 20 PLHIV, 12 CHWs for in-depth interviews and 23 TS for three focus group discussions held between September to December, 2023. The theoretical framework of acceptability guided thematic-content analysis using a framework approach.ResultsParticipants understood that PLHIV have high risk for active TB and that 3HP provides shortened treatment for TB disease prevention. They reported gaining TB and 3HP knowledge from health education sessions. However, participation of TS in health education sessions was low and many reported expensive transportation costs to clinics. Receiving support from someone close and SMS were perceived as good adherence reminders. The majority reported mild self-limiting side effects but expressed positive attitudes because of the shortened treatment, TB counselling, satisfaction from helping others, alignment with lifestyle and work responsibilities and reduced work burden. Some PLHIV reported difficulties in identifying family members for support thus, chose other close friends or CHWs.ConclusionsDelivery of 3HP with support from family members and SMS reminders is widely accepted by CHWs, PLHIVs and TS. Restricting support from only family members was unacceptable and attendance of all three health education sessions by TS may not be feasible.

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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

Cited by 5 publications

References 47 publications

Discrepancy between Mtb-specific IFN-γ and IgG responses in HIV-positive people with low CD4 counts

Discrepancy between Mtb-specific IFN-γ and IgG responses in HIV-positive people with low CD4 counts

Prevalence and predictors of tuberculosis among HIV patients who completed isoniazid preventive therapy (IPT) at Reach out Mbuya community health initiative

Optimizing delivery strategies for 3HP TB preventive treatment in Tanzania: A qualitative study on acceptability of family approach in HIV care and treatment centers

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