Implementation of isoniazid preventive therapy in people living with HIV in Zambia: challenges and lessons
- PMID: 31640657
- PMCID: PMC6805296
- DOI: 10.1186/s12889-019-7652-x
Implementation of isoniazid preventive therapy in people living with HIV in Zambia: challenges and lessons
Abstract
Background: Uptake of Isoniazid Preventive Therapy (IPT) among People Living with HIV in Zambia has continued to be low despite various evidence for its added benefit in reducing TB incidence and mortality when taken with antiretroviral therapy. In 2017, only 18% of People Living with HIV newly enrolled in care were initiated on IPT in Zambia.
Main text: Various challenges including policy and management level factors, supply chain factors, health worker perceptions about IPT, monitoring and evaluation factors and limited demand creation activities have constrained the scale up of IPT in Zambia. Lessons that have been learnt while addressing the above challenges are shared and they can be applied by government ministries, project managers, public health specialists to strengthen IPT activities in their settings.
Conclusion: Zambia has both a high burden of TB and HIV and without preventing new cases of TB from reactivation of latent TB infection, it will be difficult to control TB. All stakeholders involved in prevention of TB among PLHIV need to commit to addressing the challenges limiting scale up of IPT.
Keywords: Chemoprophylaxis; HIV; Health policy; Prevention; Tuberculosis.
Conflict of interest statement
The authors declare that they have no competing interests.
References
-
- World Health Organisation. Global Tuberculosis Report 2018 [cited 2019 15 August]; Available from: https://www.who.int/tb/publications/global_report/en/.
-
- World Health Organisation. Global Tuberculosis Report 2017. [cited 2019 15 August]; Available from: http://www.who.int/tb/publications/global_report/gtbr2017_main_text.pdf?....
-
- Suthar AB, Lawn SD, del Amo J, Getahun H, Dye C, Sculier D, Sterling TR, Chaisson RE, Williams BG, Harries AD, et al. Antiretroviral therapy for prevention of tuberculosis in adults with HIV: a systematic review and meta-analysis. PLoS Med. 2012;9(7):e1001270. doi: 10.1371/journal.pmed.1001270. - DOI - PMC - PubMed
-
- Badje A, Moh R, Gabillard D, Guehi C, Kabran M, Ntakpe JB, Carrou JL, Kouame GM, Ouattara E, Messou E, et al. Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial. Lancet Glob Health. 2017;5(11):e1080–e1089. doi: 10.1016/S2214-109X(17)30372-8. - DOI - PubMed
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical