Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries

International epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish (US)
Article numbere0153243
JournalPLoS One
Volume11
Issue number4
DOIs
StatePublished - Apr 1 2016

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isoniazid
Isoniazid
Infection Control
tuberculosis
disease control
income
Tuberculosis
HIV
therapeutics
Screening
screening
signs and symptoms (animals and humans)
control methods
Therapeutics
Tuberculin
tuberculin
skin tests
Central Africa
Southern Africa
Central America

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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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. / International epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration.

In: PLoS One, Vol. 11, No. 4, e0153243, 01.04.2016.

Research output: Contribution to journalArticle

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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.",
author = "{International epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration} and Charles, {M. Katherine} and Lindegren, {Mary Lou} and Wester, {C. William} and Meridith Blevins and Sterling, {Timothy R.} and Dung, {Nguyen Thi} and Dusingize, {Jean Claude} and Divine Avit-Edi and Nicolas Durier and Barbara Castelnuovo and Gertrude Nakigozi and Cortes, {Claudia P.} and Marie Ballif and Lukas Fenner and Samuel Ajayi and Kathryn Anastos and Jules Bashi and William Bishai and Andrew Boulle and Paula Braitstein and Gabriela Carriquiry and Carter, {Jane E.} and Peter Cegielski and Cleophas Chimbetete and Davies, {Mary Ann} and Lameck Diero and Stephany Duda and Matthias Egger and Eboua, {Tanoh F.} and Adrian Gasser and Elvin Geng and Gnokori, {Joachim Charles} and Laura Hardwicke and Chris Hoffmann and Robin Huebner and Nzali Kancheya and Sasisopin Kiertiburanakul and Peter Kim and Diero Lameck and Val{\'e}riane Leroy and Charlotte Lewden and Anna Mandalakas and Mhairi Maskew and Rosemary McKaig and Lynne Mofenson and Mireille Mpoudi-Etame and Benson Okwara and Sam Phiri and Wasana Prasitsuebsai and Kara Wools-Kaloustian",
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AU - International epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration

AU - Charles, M. Katherine

AU - Lindegren, Mary Lou

AU - Wester, C. William

AU - Blevins, Meridith

AU - Sterling, Timothy R.

AU - Dung, Nguyen Thi

AU - Dusingize, Jean Claude

AU - Avit-Edi, Divine

AU - Durier, Nicolas

AU - Castelnuovo, Barbara

AU - Nakigozi, Gertrude

AU - Cortes, Claudia P.

AU - Ballif, Marie

AU - Fenner, Lukas

AU - Ajayi, Samuel

AU - Anastos, Kathryn

AU - Bashi, Jules

AU - Bishai, William

AU - Boulle, Andrew

AU - Braitstein, Paula

AU - Carriquiry, Gabriela

AU - Carter, Jane E.

AU - Cegielski, Peter

AU - Chimbetete, Cleophas

AU - Davies, Mary Ann

AU - Diero, Lameck

AU - Duda, Stephany

AU - Egger, Matthias

AU - Eboua, Tanoh F.

AU - Gasser, Adrian

AU - Geng, Elvin

AU - Gnokori, Joachim Charles

AU - Hardwicke, Laura

AU - Hoffmann, Chris

AU - Huebner, Robin

AU - Kancheya, Nzali

AU - Kiertiburanakul, Sasisopin

AU - Kim, Peter

AU - Lameck, Diero

AU - Leroy, Valériane

AU - Lewden, Charlotte

AU - Mandalakas, Anna

AU - Maskew, Mhairi

AU - McKaig, Rosemary

AU - Mofenson, Lynne

AU - Mpoudi-Etame, Mireille

AU - Okwara, Benson

AU - Phiri, Sam

AU - Prasitsuebsai, Wasana

AU - Wools-Kaloustian, Kara

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AB - 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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