Correlates of adherence and utilization of Isoniazid preventive therapy in HIV patients

Abstract

Objective: Isoniazid (INH) is given to individuals with latent infection of tuberculosis in order to prevent progression to active disease. It is important to understand factors associated with non-adherence to prophylactic Isoniazid. This study aimed to identify correlates of adherence and utilization of Isoniazid in HIV positive patients and to explore the opinions of patients and health care providers. Methods: Participants eligible for the study were 403 randomly selected HIV positive individuals taking INH on follow up in Yekatit 12 hospital. Adherence was measured by self-report of INH tablets taken for past 3, 7 and 30 days. In depth interview was also conducted on recruited patients and health professionals. Results: Adherence to INH was 94% for last 7 days. INH related common side effects were reported by 142 participants (35.2%) and only 53 (13.2%) discontinued. The odds of adherence was 104, 7.7 and 34.8 [95% Confidence Interval (18.7, 582.6), (2.6, 22.9) and (4.4, 272.6)] times higher among those patients who did not have jaundice, skin rash and seizure compared to those who developed, respectively. Conclusion: The prevalence of adherence to INH in Yekatit 12 hospital was better than other local and African studies and the reasons for poor adherence was strongly associated with occurrence of jaundice, skin rash and seizure. Comprehensive care and support, sustainable drug supply and evaluation of side effects are recommended.

Isoniazid Preventive Therapy: Level of Adherence and Its Determinant Factors among HIV Positive Patients in Adama Hospital Medical College, Oromia, Ethiopia, 2016

“…Seven days self-reported adherence rate of this study was 68.5% which is less than the prevalence found in a study done at yekatit 12 Hospital (94%) [22]. Other two facility based cross sectional studies conducted at Addis Ababa also showed higher rates of IPT adherence (86.5% and 89.5%) [12,13].…”

Dotting the Three I's for collaborative TB-HIV activities: evaluation of a pilot programme in Kathmandu, Nepal

“…23,24 The majority of events were due to hepatotoxicity and gastrointestinal effects. The attribution of adverse events to IPT was made by the clinician; the exact cause, however, was not assessed in the study.…”

Knowledge and adherence to isoniazid preventive therapy among people living with HIV (PLHIV) in multilevel health facilities in South-East, Nigeria: baseline findings from a quasi-experimental study

“…This similarity is not surprising since both studies were carried out in the same setting. Several other previous studies have also reported high levels of adherence to IPT [ 12 , 17 , 18 ]. The good adherence to therapy observed in this study may be because these patients were already on antiretroviral therapy and quality adherence counseling for the antiretroviral drugs is part of the routine activities for HIV care and therefore could influence adherence to any other treatment given a longside the ARDs.…”

“…Some studies have reported low level of knowledge of latent TB and the IPT guideline [ 5 , 11 ]. Studies have shown that adherence rates for Isoniazid Preventive Therapy vary significantly from 34%-98% [ 12 - 17 ]. Adherence can be improved if patients have good knowledge of the needs and benefits of IPT and this can be facilitated through counseling of these patients by healthcare workers [ 4 , 18 ].…”