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Isoniazid preventive therapy: Uptake, incidence of tuberculosis and survival among people living with HIV in Bulawayo, Zimbabwe


Autoři: Saziso Nyathi aff001;  Riitta A. Dlodlo aff002;  Srinath Satyanarayana aff002;  Kudakwashe C. Takarinda aff002;  Hannock Tweya aff005;  Sithokozile Hove aff001;  Ronnie Matambo aff003;  Winnie Mandewo aff007;  Khulamuzi Nyathi aff001;  Edwin Sibanda aff001;  Anthony D. Harries aff002
Působiště autorů: Health Services Department, City of Bulawayo, Bulawayo, Zimbabwe aff001;  International Union Against Tuberculosis and Lung Disease (The Union), Paris, France aff002;  International Union Against Tuberculosis and Lung Disease (The Union), Harare, Zimbabwe aff003;  AIDS and TB Directorate, Ministry of Health and Child Care, Harare, Zimbabwe aff004;  Light House Trust, Lilongwe, Malawi aff005;  Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, England, United Kingdom aff006;  Elizabeth Glaser Peadiatric AIDS Foundation, Harare, Zimbabwe aff007
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223076

Souhrn

Setting

Four primary health care clinics providing tuberculosis (TB) and Human Immunodeficiency Virus care services in Bulawayo, Zimbabwe.

Objectives

To assess isoniazid preventive therapy (IPT) initiation and completion, factors associated with IPT uptake and incidence of TB, and TB and antiretroviral treatment (ART) outcomes among people living with HIV (PLHIV).

Design

This was a cohort study using routine data in the records for PLHIV initiated on ART from October 2013 to March 2014 with 31 December 2017 as the end of the follow-up period.

Results

A total of 408 PLHIV were eligible for IPT, 214 (52%) were initiated on IPT and 201 (94%) completed IPT. No person in the IPT-initiated group developed Tuberculosis (TB). Six persons with TB were reported among the non-IPT-initiated group leading to an incidence of 9 cases/1,000 person-years of follow-up. About 70% of those who developed and were treated for TB had a successful TB treatment outcome. The survival on ART at four years of follow-up was 88% among the IPT-initiated PLHIV that was significantly higher than the 75% survival in the group not- initiated on IPT.

Conclusion

The study revealed low IPT initiation among eligible PLHIV who, if started on IPT, completed the six month regimen. TB was reported only among the PLHIV not-initiated on IPT and the four year ART survival was higher in the IPT-initiated group than in the non-initiated group. These findings reinforce the need to strengthen IPT uptake among PLHIV in Bulawayo.

Klíčová slova:

Age groups – HIV prevention – Isoniazid – Tuberculosis – Tuberculosis diagnosis and management – Zimbabwe


Zdroje

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