UPTAKE OF ISONIAZID PREVENTIVE THERAPY AND PATIENT ASSOCIATED FACTORS IN ADULT PLHIV ON CHRONIC HIV CARE AT SPHMMC ART CLINIC. ADDIS ABABA, ETHIOPIA

Abstract

ABSTRACT BACKGROUND: Management of latent tuberculosis (TB) infection (LTBI) is one of the globally recommended key strategies to end TB. Patients living with human immune deficiency virus (PLHIV) and under-five children were the two groups recommended to receive Isoniazid Preventive Therapy (IPT) according to the earlier versions of world health organization (WHO) guidelines, and most high burden countries adopted this recommendation. However, there is limited experience with translation of global recommendations into action at country levels. Ethiopia has adopted this policy in 2008 as a pilot that has since been rapidly rolled out nationally even though IPT uptake remains very low in the country. OBJECTIVE: The overall aim of the study was to access the uptake of IPT and patient associated factors among IPT-eligible PLHIV and on chronic HIV care follow up at Saint Paul’s Millennium Medical Collage (SPHMMC) antiretroviral therapy (ART) clinic. METHOD: Institution based Retrospective Descriptive study was conducted in this study. Data was extracted from 350 eligible patients living with human immune deficiency virus and on chronic HIV care at ART clinic from patient charts to calculate the proportion of IPT uptake among eligible PLHIV. Bivariate analysis, followed by simple binary and multivariable logistic regression analyses was used to identify patient associated factors with uptake of IPT. 95% Confidence intervals and (p) < 0.05 were used to measure significance of associations between uptakes of IPT versus independent variables. RESULT: Proportion of eligible PLHIV who had been ever provided with IPT was 55 (16%). The clients within the age range of 30-39 years (AOR17.07, 95% CI: 1.96.14.97) had significant higher IPT uptake rate compared to those age above 50.Clients living in Addis Ababa (AOR 52.90, 95% CI: 2.91- 9.08) had significant higher uptake rates when compared to their counterparts from other towns. Clients with high level of education (AOR 23.43, 95%CI: 1.29-4.26) had higher uptake rate than those with low educational status. Clients who presented with early disease stage (AOR15.27, 95% CI: 1.19-19.06) had higher IPT uptake rate when compared with their counterparts who presented at advanced stage of their disease. Clients less than three years since enrollment into HIV care (AOR 0.07, 95%CI: 0.01-0.46) and those with poor functional status at enrollment (AOR 0.03, 95% CI: 0.01-0.96) had significantly low IPT uptake in comparison with those who were enrolled for more than five years and with good functional status at enrollment respectively. IPT uptake was significantly lower among Clients who were on HAART for less than 6months (AOR 0.04, 95%CI: 0.04-0.54) when compared with those on treatment for more than a year. CONCLUSION AND RECOMMENDATION: In this study the IPT courage at SPHMMC Chronic HIV Care Unit was considerably low. The uptake was significantly lower among the following patient variables: old age, clients living outside of Addis Ababa, low educational status, advanced disease stage (WHO stage 4) and clients with poor functional status, new to care clients as well as those on HAART for short duration. Another study of this nature with the objective to find out the reason behind low uptake in this group of clients is recommended.