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Beneficial effect of isoniazid preventive therapy and antiretroviral therapy on the incidence of tuberculosis in people living with HIV in Ethiopia

PLoS ONE, ISSN: 1932-6203, Vol: 9, Issue: 8, Page: e104557
2014
  • 63
    Citations
  • 0
    Usage
  • 231
    Captures
  • 1
    Mentions
  • 19
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    63
  • Captures
    231
  • Mentions
    1
    • News Mentions
      1
      • News
        1
  • Social Media
    19
    • Shares, Likes & Comments
      19
      • Facebook
        19

Most Recent News

PROvide MIner-friendly SErvices for Integrated TB/HIV Care in Lesotho Study; PROMISE

STUDY INFORMATION OFFICIAL TITLE: PROvide MIner-friendly SErvices for Integrated TB/HIV Care in Lesotho Study (PROMISE Study) CURRENT STATUS: Recruiting STUDY TYPE: Interventional SPONSOR AGENCY:Columbia UniversityCLASS:Other

Article Description

Background: IPT with or without concomitant administration of ART is a proven intervention to prevent tuberculosis among PLHIV. However, there are few data on the routine implementation of this intervention and its effectiveness in settings with limited resources. Objectives: To measure the level of uptake and effectiveness of IPT in reducing tuberculosis incidence in a cohort of PLHIV enrolled into HIV care between 2007 and 2010 in five hospitals in southern Ethiopia. Methods: A retrospective cohort analysis of electronic patient database was done. The independent effects of no intervention, "IPT-only," "IPT-before-ART," "IPT-and-ART started simultaneously," "ART-only," and "IPT-after-ART" on TB incidence were measured. Cox-proportional hazards regression was used to assess association of treatment categories with TB incidence. Results: Of 7,097 patients, 867 were excluded because they were transferred-in; a further 823 (12%) were excluded from the study because they were either identified to have TB through screening (292 patients) or were on TB treatment (531). Among the remaining 5,407 patients observed, IPT had been initiated for 39% of eligible patients. Children, male sex, advanced disease, and those in Pre-ART were less likely to be initiated on IPT. The overall TB incidence was 2.6 per 100 person-years. As compared to those with no intervention, use of "IPT-only" (aHR = 0.36, 95% CI = 0.19-0.66) and "ART-only" (aHR = 0.32, 95% CI = 0.24-0.43) were associated with significant reduction in TB incidence rate. Combining ART and IPT had a more profound effect. Starting IPT-before-ART (aHR = 0.18, 95% CI = 0.08-0.42) or simultaneously with ART (aHR = 0.20, 95% CI = 0.10-0.42) provided further reduction of TB at ∼80%. Conclusions: IPT was found to be effective in reducing TB incidence, independently and with concomitant ART, under programme conditions in resource-limited settings. The level of IPT provision and effectiveness in reducing TB was encouraging in the study setting. Scaling up and strengthening IPT service in addition to ART can have beneficial effect in reducing TB burden among PLHIV in settings with high TB/HIV burden.

Bibliographic Details

http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84905668722&origin=inward; http://dx.doi.org/10.1371/journal.pone.0104557; http://www.ncbi.nlm.nih.gov/pubmed/25105417; https://dx.plos.org/10.1371/journal.pone.0104557.t004; http://dx.doi.org/10.1371/journal.pone.0104557.t004; https://dx.plos.org/10.1371/journal.pone.0104557.t002; http://dx.doi.org/10.1371/journal.pone.0104557.t002; https://dx.plos.org/10.1371/journal.pone.0104557.t003; http://dx.doi.org/10.1371/journal.pone.0104557.t003; https://dx.plos.org/10.1371/journal.pone.0104557; https://dx.plos.org/10.1371/journal.pone.0104557.g001; http://dx.doi.org/10.1371/journal.pone.0104557.g001; https://dx.plos.org/10.1371/journal.pone.0104557.t001; http://dx.doi.org/10.1371/journal.pone.0104557.t001; https://dx.doi.org/10.1371/journal.pone.0104557; https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0104557; https://dx.doi.org/10.1371/journal.pone.0104557.t003; https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0104557.t003; https://dx.doi.org/10.1371/journal.pone.0104557.t002; https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0104557.t002; https://dx.doi.org/10.1371/journal.pone.0104557.g001; https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0104557.g001; https://dx.doi.org/10.1371/journal.pone.0104557.t001; https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0104557.t001; https://dx.doi.org/10.1371/journal.pone.0104557.t004; https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0104557.t004; http://dx.plos.org/10.1371/journal.pone.0104557.t001; https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0104557&type=printable; http://dx.plos.org/10.1371/journal.pone.0104557.t004; http://www.plosone.org/article/metrics/info:doi/10.1371/journal.pone.0104557; http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0104557&type=printable; http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0104557; http://dx.plos.org/10.1371/journal.pone.0104557.t003; http://dx.plos.org/10.1371/journal.pone.0104557; http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0104557; http://dx.plos.org/10.1371/journal.pone.0104557.t002; http://dx.plos.org/10.1371/journal.pone.0104557.g001

Kesetebirhan Delele Yirdaw; Degu Jerene; Zewdu Gashu; M. E. Edginton; Ajay M. V. Kumar; Yohannes Letamo; Beniam Feleke; Alula M. Teklu; Solomon Zewdu; Bill Weiss; Andrea Ruff; Emma S. McBryde

Public Library of Science (PLoS)

Multidisciplinary

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