Impact of Isoniazid Preventive Therapy Intervention among people living with HIV in Zanzibar

Abstract

Background: Treatment of people with latent TB infection using isoniazid preventive therapy (IPT) can reduce the risk of latent TB infection progressing to TB disease by 60% to 90%, therefore, the WHO recommends IPT for PLHIV as part of TB prevention. Broad Objective: To assess Impact of Isoniazid Preventive Therapy (IPT) Intervention among People living with HIV in Zanzibar. Methods: A total of 345 clients were included in this study. Cross-sectional study design employing quantitative and qualitative approach was used in this study. For quantitative approach, participants were purposively selected each day as they were coming until the required number of 345 was reached, while for qualitative part a convenient sampling to health care provider were used to conduct in-depth interviews so as to assess their level of knowledge on IPT, data were collected using both pre-tested administered structured questionnaire and interview guide. Data were analyzed using descriptive statistics, binary and multivariable regression analysis with 95% confidence interval was carried out and P-value less than 0.05 were considered significant for quantitative data and thematic analysis methods for qualitative data. Results: IPT significantly reduced the incidence of TB by 96% (AOR: 0.040 (0.007-0.232). Factors associated TB were, TB assessment (AOR: 0.084 (0.024-0.295) 91.6% reduction in TB incidence. TB treatment (AOR: 0.483 (0.134-0.735) 51.7% reduction in TB incidence. IPT completed dose (AOR: 0.261 (0.060-0.436), 73.9% reduction in TB incidence and IPT uptake (AOR: 0.040 (0.007-0.232) 96% reduction in TB incidence. The qualitative study identified high knowledge on IPT among health care workers in Zanzibar, Conclusion: Isoniazid preventive therapy (IPT) has shown to be effective in reducing TB incidence among PLHIV in Zanzibar. More efforts are needed to increase the provision of isoniazid drugs and coverage of IPT to People Living with HIV in Zanzibar.