Article ; Online: Provider barriers to the uptake of isoniazid preventive therapy among people living with HIV in Ethiopia
2019 Volume 23, Issue 3, Page(s) 371–377
Abstract: Setting: Sixty-seven government health facilities providing tuberculosis (TB) and human immunodeficiency virus (HIV) services across Ethiopia.: Objective: To examine clinician barriers to implementing isoniazid preventive therapy (IPT) among people ... ...
Abstract | Setting: Sixty-seven government health facilities providing tuberculosis (TB) and human immunodeficiency virus (HIV) services across Ethiopia. Objective: To examine clinician barriers to implementing isoniazid preventive therapy (IPT) among people living with HIV. Design: A cross-sectional study to evaluate the provider-related factors associated with high IPT coverage at the facility level. Results: On bivariate analysis, the odds of high IPT implementation were lower when clinicians felt patients were negatively affected by the side effects of IPT (OR 0.18, 95%CI 0.04-0.81) and perceived that IPT increased multidrug-resistant TB (MDR-TB) rates (OR 0.66, 95%CI 0.44-0.98). The presence of IPT guidelines on site (OR 2.93, 95%CI 1.10-7.77) and TB-HIV training (OR 3.08, 95%CI 1.11-8.53) had a positive relationship with high IPT uptake. In the multivariate model, clinician's perception that active TB was difficult to rule out had a negative association with a high IPT rate (OR 0.93; 95%CI 0.90-0.95). Conclusions: Clinician impression that ruling out active TB among HIV patients is difficult was found to be a significant barrier to IPT uptake. Continued advancement of IPT relies greatly on improving the ability of providers to determine IPT eligibility and more confidently care for patients on IPT. Improved clinician support and training as well as development of new TB diagnostic technologies could impact IPT utilization among providers. |
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MeSH term(s) | Adult ; Antitubercular Agents/administration & dosage ; Antitubercular Agents/adverse effects ; Attitude of Health Personnel ; Cross-Sectional Studies ; Ethiopia/epidemiology ; Female ; HIV Infections/complications ; Health Care Surveys ; Humans ; Isoniazid/administration & dosage ; Isoniazid/adverse effects ; Male ; Middle Aged ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/statistics & numerical data ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control ; Young Adult |
Chemical Substances | Antitubercular Agents ; Isoniazid (V83O1VOZ8L) |
Language | English |
Publishing date | 2019-03-15 |
Publishing country | France |
Document type | Journal Article ; Multicenter Study ; Research Support, U.S. Gov't, P.H.S. |
ZDB-ID | 1385624-8 |
ISSN | 1815-7920 ; 1027-3719 |
ISSN (online) | 1815-7920 |
ISSN | 1027-3719 |
DOI | 10.5588/ijtld.18.0378 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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