Assessing the Impact of Isoniazid Preventive Therapy (IPT) on Tuberculosis Incidence and Predictors of Tuberculosis among Adult Patients Enrolled on ART in Nekemte Town, Western Ethiopia: A Retrospective Cohort Study.

Gemechu Tiruneh,Alemayehu Getahun,Emiru Adeba

doi:10.1155/2019/1413427

Gemechu Tiruneh, Alemayehu Getahun + Show 1 more

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https://doi.org/10.1155/2019/1413427

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Abstract

Background Isoniazid preventive therapy is a prophylactic treatment used in the prevention of active tuberculosis. It is known to be most effective in preventing tuberculosis in patients with positive tuberculin skin test. Methods A retrospective cohort study centering on two institutions in Nekemte town, Western Ethiopia, was employed. Secondary data of 600 medical records were analyzed by Cox regression. Result Tuberculosis incidence among the Isoniazid treated group was 1.98 per 100 person-years and 4.52 per 100 person-years in the untreated group. CD4 cell count, clinical staging, body mass index (BMI), not using cotrimoxazole, body weight, and functional status were significant predictors of tuberculosis risk. Isoniazid preventive therapy use was associated with 55% reduction of tuberculosis incidence. Conclusion Isoniazid preventive therapy use was associated with significant reduction in tuberculosis incidence, even in the absence of Tuberculin Skin Test (TST). Therefore, isoniazid preventive therapy (IPT) coverage should be used more widely, with special emphasis given to patients at higher risk of tuberculosis. The study shows that the absence of TST testing should not be a limitation.

Highlights

Isoniazid preventive therapy is a prophylactic treatment used in the prevention of active tuberculosis
Tuberculosis (TB) is the commonest of all opportunistic infections in people living with Human Immune Deficiency Virus (HIV) and causes preventable Acquired Immune Deficiency Syndromes (AIDS) related mortality and morbidity, especially in sub-Saharan Africa
This study aims to review the effectiveness of isoniazid preventive therapy (IPT) in a country like Ethiopia where TST and other techniques used to diagnose latent tuberculosis infections (LTBI) are absent

Summary

Introduction

Isoniazid preventive therapy is a prophylactic treatment used in the prevention of active tuberculosis. It is known to be most effective in preventing tuberculosis in patients with positive tuberculin skin test. Isoniazid preventive therapy use was associated with 55% reduction of tuberculosis incidence. Isoniazid preventive therapy use was associated with significant reduction in tuberculosis incidence, even in the absence of Tuberculin Skin Test (TST). Isoniazid preventive therapy (IPT) coverage should be used more widely, with special emphasis given to patients at higher risk of tuberculosis. The effectiveness of IPT in preventing TB has been well established in HIV-negative individuals and communities as well as in HIV-infected populations [2,3,4]. The greatest benefit of IPT in preventing TB is clearly established for people with confirmed latent TB infection which is diagnosed by a positive TST [5, 6]

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