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Biomarker-confirmed suboptimal adherence to isoniazid preventive therapy among children with HIV in western Kenya Instituut voor Tropische Geneeskunde

D Onyango, Courtney M. Yuen, Joyce A. Were, Jerphason Mecha, LN Njagi, N Panpradist, Daniel Matemo, D Leon, B Lutz, John Kinuthia, et al.
Objectives:
The aim of this study was to assess the level and correlates of biomarker-confirmed adherence to isoniazid (INH) preventive therapy (IPT) among children with HIV (CLHIV).

Design:
This prospective cohort study assessed adherence among CLHIV on IPT in public sector HIV clinics from 2019 through 2020.

Methods:
Adherence was assessed by pill counts or caregiver or self-reports, and urine biomarkers ...

Incidence, risk factors and interventions addressing mortality associated with HIV and TB infections among children and adults in Kenya Instituut voor Tropische Geneeskunde

Dickens Otieno Onyango
Tuberculosis (TB) and infection with human immuno-deficiency virus (HIV) are leading infectious causes of morbidity particularly in sub-Saharan Africa, which is disproportionately affected by the two epidemics. Kenya is one of the 30 countries with the highest HIV and TB burden in the world. Kenya’s HIV prevalence was estimated to be 4,900 per 100,000 in 2019 while TB prevalence was 558 per 100,000 population in a 2016 survey. Estimates of ...

Isoniazid preventive therapy completion in children under 5 years old who are contacts of tuberculosis cases in Lima, Peru: study protocol for an open-label, cluster-randomized superiority trial Instituut voor Tropische Geneeskunde Universiteit Gent

Larissa Otero Vegas, N Zetola, M Campos, J Zunt, A Bayer, M Curisinche, Theresa Jean Ochoa, R. Moreno-Reyes, Victor Vega, Patrick Van der Stuyft, et al.
Background
Children < 5 years old in contact with TB cases are at high risk for developing severe and fatal forms of TB. Contact investigation, BCG vaccination, and isoniazid preventive therapy (IPT) are the most effective strategies to prevent TB among children. However, the implementation of IPT faces challenges at several stages of the cascade of care of TB infection among children, particularly those less than 5 years old. In Peru, a ...

Drop-offs in the isoniazid preventive therapy cascade among children living with HIV in western Kenya, 2015-2019 Instituut voor Tropische Geneeskunde

Dickens Otieno Onyango, Marianne A. B. van der Sande, Courtney M. Yuen, Jerphason Mecha, Daniel Matemo, Elizabeth Oele, John Kinuthia, Grace John-Stewart, Sylvia M. LaCourse

INTRODUCTION: Isoniazid preventive therapy (IPT) can reduce the risk of tuberculosis (TB) in children living with HIV (CLHIV), but data on the outcomes of the IPT cascade in CLHIV are limited.

METHODS: We evaluated the IPT cascade among CLHIV aged <15 years and newly enrolled in HIV care in eight HIV clinics in western Kenya. Medical record data were abstracted from September 2015 through July 2019. We assessed the proportion of ...

Contact evaluation and isoniazid preventive therapy among close and household contacts of tuberculosis patients in Lima, Peru: an analysis of routine data Instituut voor Tropische Geneeskunde Universiteit Gent

Larissa Otero, Tullia Battaglioli, Julia Ríos, Zayda De la Torre, Nayda Trocones, Cielo Ordoñez, Carlos Seas, Patrick Van der Stuyft

OBJECTIVE: Contacts of pulmonary tuberculosis (TB) cases are at high risk of TB infection and progression to disease. Close and household contacts and those <5 years old have the highest risk. Isoniazid preventive therapy (IPT) can largely prevent TB disease among infected individuals. International and Peruvian recommendations include TB contact investigation and IPT prescription to eligible contacts. We conducted a study in Lima, Peru, ...

Factors associated with mortality in persons co-infected with tuberculosis and HIV in Suriname: a retrospective cohort study Universiteit Hasselt

Deborah STIJNBERG, Eric Commiesie, Diana Marin, Ward SCHROOTEN, Freddy Perez, Mauro Sanchez
Objective. To identify socio-demographic and clinical factors associated with mortality among persons with tuberculosis (TB) and TB/HIV co-infection in Suriname. Methods. This was a retrospective cohort study using data from the national TB and HIV databases for 2010 2015. The survival probability of TB and TB/HIV co-infected patients was analyzed using the Kaplan-Meier estimates and the log-rank test. A Cox proportional hazard model was ...

Initiation and completion rates of isoniazid preventive therapy among people living with HIV in Far-Western Region of Nepal : a retrospective cohort study Universiteit Gent

Govinda Dhungana, Pruthu Thekkur, Palanivel Chinnakali, Usha Bhatta, Basudev Pandey, Wei Hong Zhang
Objectives: Isoniazid preventive therapy (IPT), for people living with HIV (PLHIV) is the proven and recommended intervention to avert tuberculosis (TB). In 2015, Nepal implemented 6 months of IPT for all PLHIV registered for HIV care in antiretroviral therapy (ART) centres. After programmatic implementation, there has been no systematic assessment of IPT initiation and completion rates among PLHIV. We aimed to assess IPT initiation and ...

Health system barriers to implementation of TB preventive strategies in South African primary care facilities Universiteit Antwerpen

Eva Van Ginderdeuren, Jean Bassett, Colleen Hanrahan, Lillian Mutunga, Annelies Van Rie
Background Isoniazid preventive therapy (IPT) is a key component of TB/HIV control, but few countries achieve high IPT coverage. Methods Using a behavioural COM-B design approach, the intervention consisted of a training on IPT guidelines and tuberculin skin testing (TST), identification of the optimal IPT implementation strategy by the health care workers (HCWs) of 3 primary care clinics, and a 2-month mentoring period. Using routine register ...

Evaluation of the intensified tuberculosis case finding guidelines for children living with HIV Universiteit Antwerpen

S. Sawry, H. Moultrie, Annelies Van Rie
SETTING: Out-patient paediatric human immunodeficiency virus (HIV) clinic in Soweto, South Africa. OBJECTIVE: To evaluate the yield of symptom screening for intensified tuberculosis (TB) case finding (ICF) and potential eligibility for isoniazid preventive therapy (IPT) in children living with HIV on antiretroviral treatment (ART). DESIGN: A cohort of 247 children (age 0-8 years) was systematically screened for TB symptoms during the first 2 ...

Stigma as a barrier to the use of occupational health units for tuberculosis services in South Africa Universiteit Antwerpen

Nina Sommerland, Edwin Wouters, Caroline Masquillier, M. Engelbrecht, G. Kigozi, K. Uebel, A. Janse van Rensburg, A. Rau
SETTING: Tuberculosis (TB) is the leading cause of death in South Africa, and health care workers (HCWs) are disproportionally affected. The resulting absenteeism strains the already overburdened health system. Although hospital occupational health care units (OHUs) are cost-effective and of crucial importance in tackling the TB epidemic, the fear of being stigmatised by other colleagues might lead HCWs to avoid using OHUs. OBJECTIVE : To ...