BACKGROUND: Tuberculosis preventive treatment (TPT) reduces the development of tuberculosis (TB) disease and mortality in people living with human immunodeficiency virus (HIV) infection. Despite this known effectiveness, global uptake of TPT has been slow. We aimed to assess current status of TPT implementation in countries supported by the US President's Emergency Plan for AIDS Relief (PEPFAR). METHODS: We surveyed TB-HIV program staff at US Centers for Disease Control and Prevention (CDC) country offices in 42 PEPFAR-supported countries about current TPT policies, practices, and barriers to implementation. Surveys completed from July to December 2017 were analyzed. RESULTS: Of 42 eligible PEPFAR-supported countries, staff from 35 (83%) CDC country offices completed the survey. TPT was included in national guidelines in 33 (94%) countries, but only 21 (60%) reported nationwide programmatic TPT implementation. HIV programs led TPT implementation in 20/32 (63%) countries, but TB programs led drug procurement in 18/32 (56%) countries. Stock outs were frequent, as 21/28 (75%) countries reported at least one isoniazid stock out in the previous year. CONCLUSION: Despite widespread inclusion of TPT in guidelines, programmatic TPT implementation lags. Successful scale-up of TPT requires uninterrupted drug supply chains facilitated by improved leadership and coordination between HIV and TB programs.
BACKGROUND:Tuberculosis preventive treatment (TPT) reduces the development of tuberculosis (TB) disease and mortality in people living with human immunodeficiency virus (HIV) infection. Despite this known effectiveness, global uptake of TPT has been slow. We aimed to assess current status of TPT implementation in countries supported by the US President's Emergency Plan for AIDS Relief (PEPFAR). METHODS: We surveyed TB-HIV program staff at US Centers for Disease Control and Prevention (CDC) country offices in 42 PEPFAR-supported countries about current TPT policies, practices, and barriers to implementation. Surveys completed from July to December 2017 were analyzed. RESULTS: Of 42 eligible PEPFAR-supported countries, staff from 35 (83%) CDC country offices completed the survey. TPT was included in national guidelines in 33 (94%) countries, but only 21 (60%) reported nationwide programmatic TPT implementation. HIV programs led TPT implementation in 20/32 (63%) countries, but TB programs led drug procurement in 18/32 (56%) countries. Stock outs were frequent, as 21/28 (75%) countries reported at least one isoniazid stock out in the previous year. CONCLUSION: Despite widespread inclusion of TPT in guidelines, programmatic TPT implementation lags. Successful scale-up of TPT requires uninterrupted drug supply chains facilitated by improved leadership and coordination between HIV and TB programs.
Authors: Andrew T Boyd; Dennis Kenyi Lodiongo; John Mondi Benson; Shambel Aragaw; Margaret Semira Pasquale; Habtamu Ayalneh; Robert Olemukan; Isaac Avaku; Nicholas Baabe; Victoria Achut; Helen Chun; Sudhir Bunga Journal: Bull World Health Organ Date: 2020-10-28 Impact factor: 9.408
Authors: Clay Roscoe; Chris Lockhart; Michael de Klerk; Andrew Baughman; Simon Agolory; Michael Gawanab; Heather Menzies; Anna Jonas; Natanael Salomo; Negussie Taffa; David Lowrance; Katherine Robsky; Deanna Tollefson; Eric Pevzner; Ndapewa Hamunime; Farai Mavhunga; Helena Mungunda Journal: BMC Public Health Date: 2020-12-01 Impact factor: 3.295
Authors: Michael Melgar; Ray W Shiraishi; Clifford Tende; Sydney Mwanza; Joyce Mulenga; Shepherd Khondowe; David Mwakazanga; Kelvin Kapungu; Mathias Tembo; Amos Nota; Patrick Lungu; Brittany Moore; Laura J Podewils Journal: BMC Public Health Date: 2021-05-04 Impact factor: 3.295