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Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries
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Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries
Charles, M.K.; Lindegren, M.L.; Wester, C.W.; Blevins, M.; Sterling, T.R.; Dung, N.T.; Dusingize, J.C.; Avit-Edi, D.; Durier, N.; Castelnuovo, B.; Nakigozi, G.; Cortes, C.P.; Ballif, M.; Fenner, L.; Ajayi, S.; Anastos, K.; Bashi, J.; Bishai, W.; Boulle, A.; Braitstein, P.; Carriquiry, G.; Carter, J.E.; Cegielski, P.; Chimbetete, C.; Davies, M.-A.; Diero, L.; Duda, S.; Egger, M.; Eboua, T.F.; Gasser, A.; Geng, E.; Gnokori, J.C.; Hardwicke, L.; Hoffmann, C.; Huebner, R.; Kancheya, N.; Kiertiburanakul, S.; Kim, P.; Lameck, D.; Leroy, V.; Lewden, C.; Mandalakas, A.; Maskew, M.; McKaig, R.; Mofenson, L.; Mpoudi-Etame, M.; Okwara, B.; Phiri, S.; Prasitsuebsai, W.; Petit, A.; Prozesky, H.; Reid, S.E.; Renner, L.; Reubenson, G.; Sohn, A.; Vo, Q.; Walker, D.; Wehbe, F.; Wejse, C.; Williams, C.; Wood, R.; Wools-Kaloustian, K.; Yao, Z.; Yunihastuti, E.; Zhang, F.J.; Zhao, H.X.; Han, N.; Merati, T.P.; Wirawan, D.N.; Yuliana, F.; Ditangco, R.; Uy, E.; Bantique, R.; Phanuphak, P.; Ruxrungtham, K.; Avihingsanon, A.; Khongphattanayothin, M.; Sungkanuparph, S.; Sanmeema, N.; Chaiwarith, R.; Sirisanthana, T.; Kotarathititum, W.; Pham, T.T.; Cuong, D.D.; Ha, H.L.; Nguyen, V.K.; Bui, V.H.; Nguyen, T.D.; Sohn, A.H.; Petersen, B.; Cooper, D.A.; Law, M.G.; Jiamsakul, A.; Boettiger, D.C.; Wati, D.K.; Atmikasari, L.P.P.; Malino, I.Y.; Nallusamy, R.; Chan, K.C.; Lumbiganon, P.; Kosalaraksa, P.; Tharnprisan, P.; Udomphanit, T.; Phongsamart, W.; Wittawatmongkol, O.; Dung, K.T.K.; Lam, N.V.; An, P.N.; Loan, N.T.; Truong, H.K.; Du, T.Q.; Chau, N.H.; Do, C.V.; Ha, M.T.; Nipathakosol, P.; Kariminia, A.; Mutimura, E.; Gitembagara, A.; Tatwangire, J.; Izabelle, I.; Niyongabo, T.; Twizere, C.; Baramperanye, E.; Edmonds, A.; Yotebieng, M.; Azinyue, I.; Ayangma, L.; Dickinson, D.; Eley, B.; Fritz, C.; Garone, D.; Giddy, J.; MacPhail, P.; Moultrie, H.; Ndirangu, J.; Pestilli, S.; Rabie, H.; Stringer, J.; Technau, K.; Graber, C.; Kaeser, F.; Keiser, O.; Cornell, M.; Maxwell, N.; Zannou, D.M.; Ahouada, C.; Akakpo, J.; Ahomadegbé, C.; Gougounon-Houéto, A.; Azon-Kouanou, A.; Houngbé, F.; Sehonou, J.; Koumakpaï, S.; Alihonou, F.; D'Almeida, M.; Hodonou, I.; Hounhoui, G.; Sagbo, G.; Tossa-Bagnan, L.; Adjide, H.; Drabo, J.; Bognounou, R.; Dienderé, A.; Traore, E.; Zoungrana, L.; Zerbo, B.; Sawadogo, A.B.; Zoungrana, J.; Héma, A.; Soré, I.; Bado, G.; Tapsoba, A.; Yé, D.; Kouéta, F.; Ouedraogo, S.; Ouédraogo, R.; Hiembo, W.; Gansonré, M.; Messou, E.; Gnokoro, J.C.; Koné, M.; Kouakou, G.M.; Bosse, C.A.; Brou, K.; Assi, A.I.; Chenal, H.; Hawerlander, D.; Soppi, F.; Minga, A.; Abo, Y.; Yoboue, J.-M.; Eholié, S.P.; Amego, M.D.N.; Andavi, V.; Diallo, Z.; Ello, F.; Tanon, A.K.; Koule, S.O.; Anzan, K.C.; Guehi, C.; Aka, E.A.; Issouf, K.L.; Kouakou, J.-C.; N'Gbeche, M.-S.; Pety, T.; Kouakou, K.; Moh, M.; Yao, V.A.; Folquet, M.A.; Dainguy, M.-E.; Kouakou, C.; Méa-Assande, V.T.; Oka-Berete, G.; Zobo, N.; Acquah, P.; Kokora, M.-B.; Timité-Konan, M.; Ahoussou, L.D.; Assouan, J.K.; Sami, M.F.; Kouadio, C.; Goka, B.; Welbeck, J.; Sackey, A.; Owiafe, S.N.; Da Silva, Z.J.; Paulo, J.; Rodrigues, A.; Da Silva, D.; Medina, C.; Oliviera-Souto, I.; Østergaard, L.; Laursen, A.; Sodemann, M.; Aaby, P.; Fomsgaard, A.; Erikstrup, C.; Eugen-Olsen, J.; Maïga, M.Y.; Diakité, F.F.; Kalle, A.; Katile, D.; Traore, H.A.; Minta, D.; Cissé, T.; Dembelé, M.; Doumbia, M.; Fomba, M.; Kaya, A.S.; Traoré, A.M.; Traoré, H.; Toure, A.A.; Dicko, F.; Sylla, M.; Berthé, A.; Traoré, H.C.; Koïta, A.; Koné, N.; N'Diaye, C.; Coulibaly, S.T.; Traoré, M.; Traoré, N.; Charurat, M.; Alim, G.; Dapiap, S.; Otu; Igbinoba, F.; Benson, O.; Adebamowo, C.; James, J.; Obaseki; Osakede, P.; Olasode, J.; Seydi, M.; Sow, P.S.; Diop, B.; Manga, N.M.; Tine, J.M.; Bassabi, C.C.; Sy, H.S.; Ba, A.; Diagne, A.; Dior, H.; Faye, M.; Gueye, R.D.; Mbaye, A.D.; Patassi, A.; Kotosso, A.; Kariyare, B.G.; Gbadamassi, G.; Komi, A.; Mensah-Zukong, K.E.; Pakpame, P.; Lawson-Evi, A.K.; Atakouma, Y.; Takassi, E.; Djeha, A.; Ephoévigah, A.; Djibril, S.E.-H.; Dabis, F.; Bissagnene, E.; Arrivé, E.; Coffie, P.; Ekouevi, D.; Jaquet, A.; Sasco, A.J.; Amani, D.; Azani, J.-C.; Balestre, E.; Bessekon, S.; Bohossou, F.; Gilbert, C.; Karcher, S.; Gonsan, J.M.; Le Carrou, J.; Lenaud, S.; Nchot, C.; Malateste, K.; Yao, A.R.; Siloué, B.; Clouet, G.; Dosso, M.; Doring, A.; Kouakou, A.; Rabourdin, E.; Rivenc, J.; Anglaret, X.; Ba, B.; Essanin, J.B.; Ciaranello, A.; Datté, S.; Desmonde, S.; Diby, J.-S.E.; Gottlieb, G.S.; Horo, A.G.; Kangah, S.N.; Malvy, D.; Meless, D.; Mounkaila-Harouna, A.; Ndondoki, C.; Shiboski, C.; Tchounga, B.; Thiébaut, R.; Wandeler, G.; McGowan, C.; Cahn, P.; Gotuzzo Herencia, José Eduardo; Reyes, M.W.; Grinsztejn, B.; Pape, J.W.; Padgett, D.; Madero, J.S.
Date:
2016
Abstract:
Setting: World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), and infection control ("Three I's") for TB prevention and control among persons living with HIV. Objective: To assess the implementation of the "Three I's" of TB-control at HIV treatment sites in lower income countries. Design: Survey conducted between March-July, 2012 at 47 sites in 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central and South America, 5 (10%) Central Africa, 8 (17%) East Africa, 14 (30%) Southern Africa, and 7 (15%) West Africa. Results: ICF using symptom-based screening was performed at 38% of sites; 45% of sites used symptom-screening plus additional diagnostics. IPT at enrollment or ART initiation was implemented in only 17% of sites, with 9% of sites providing IPT to tuberculin-skin-test positive patients. Infection control measures varied: 62% of sites separated smear-positive patients, and healthcare workers used masks at 57% of sites. Only 12 (26%) sites integrated HIV-TB services. Integration was not associated with implementation of TB prevention measures except for IPT provision at enrollment (42% integrated vs. 9% nonintegrated; p = 0.03). Conclusions: Implementation of TB screening, IPT provision, and infection control measures was low and variable across regional HIV treatment sites, regardless of integration status.
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