Isoniazid preventative therapy penetrance at a community health centre in South Africa: a cross sectional study

Steyn, Johannes

Isoniazid preventative therapy penetrance at a community health centre in South Africa: a cross sectional study

Master Thesis

2022

Abstract

Background: Tuberculosis (TB) remains a major contributor to morbidity and mortality in people living with HIV (PLHIV). The use of Isoniazid preventative therapy (IPT) has been proven to be effective and safe to reduce this burden. Despite overwhelming evidence, uptake op IPT is poor. This study evaluated an urban population of PLHIV and described associations with the delivery of IPT. Methods: A retrospective folder review. Results: A total of 198 folders were reviewed of which 31 had been/currently were on IPT. In the no-IPT group the fast majority, 86%, of the patients were eligible (according to current national HIV guidelines) for IPT. Only 4% had true contraindications. Factors favouring the delivery of IPT was the duration on ART (p=0.0038) and being part of the ART adherence club(AC) system (<0.0001). Conclusion: The vast majority of patients are screened but do not receive TPT. The duration of ART increased the likelihood of a patient to receive IPT. However, patients recently started on ART are at higher risk of TB disease and will benefit greatly from IPT. Patients who were enrolled in the AC system had a higher IPT penetrance. Quality improvement cycles should be implemented to address the situation. Increasing the role that adherence clubs play may be an option for future interventions.

Keywords

family medicine

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