B Odume1, S C Meribe2, T Odusote3, M Ifunanya1, H Debem1, I Amazue-Ezeuko2,4, O Ogbanufe1, Y Adamu2, D Onotu1. 1. Division of Global HIV/AIDS and TB, United States (US) Centers for Disease Control and Prevention, Abuja, Nigeria. 2. US Army Medical Research Directorate-Africa/Nigeria, Abuja, Nigeria. 3. US Agency for International Development (USAID), Abuja, Nigeria. 4. Henry Jackson Foundation for Medical Research International, Abuja, Nigeria BO and SCM contributed equally to this manuscript.
Abstract
BACKGROUND: Tuberculosis (TB) preventive therapy (TPT), including isoniazid preventive therapy (IPT), has been implemented within the Nigerian human immunodeficiency virus (HIV) programme since 2014. However, drug procurement and logistic support has remained the responsibility of the National Tuberculosis and Leprosy Control Programme. The US President's Emergency Plan for AIDS Relief-Nigeria (PEPFAR Nigeria) reviewed the key bottlenecks to TPT implementation in 2016. METHOD: The logistics of delivery of isoniazid (INH) were integrated with the antiretroviral (ARV) logistics management and information system (LMIS). Drug order and requisition forms at the facility level were revised to include INH, along with training on appropriate quantification and requisition of INH with ARVs. Support was provided for last mile delivery of INH directly to every implementing site, alongside ARV. REULTS: We observed an increasing trend in TPT uptake between the pre-and-post intervention periods: 6% in fiscal year (FY) 2015, 7% in FY2016 and 12% in FY2017. Overall, the logistical changes in the LMIS to include INH in 2016 led to a 69% increase in TPT by the end of FY2017; this was statistically significant. CONCLUSION: Addressing logistical challenges to TPT implementation will ensure that the TB and HIV programmes can tackle the increasing burden of TB infection in people living with HIV. We recommended that the provider-to-client stage of TPT implementation be driven by the HIV programme and that cross-communication between the two programmes be improved.
BACKGROUND: Tuberculosis (TB) preventive therapy (TPT), including isoniazid preventive therapy (IPT), has been implemented within the Nigerian human immunodeficiency virus (HIV) programme since 2014. However, drug procurement and logistic support has remained the responsibility of the National Tuberculosis and Leprosy Control Programme. The US President's Emergency Plan for AIDS Relief-Nigeria (PEPFAR Nigeria) reviewed the key bottlenecks to TPT implementation in 2016. METHOD: The logistics of delivery of isoniazid (INH) were integrated with the antiretroviral (ARV) logistics management and information system (LMIS). Drug order and requisition forms at the facility level were revised to include INH, along with training on appropriate quantification and requisition of INH with ARVs. Support was provided for last mile delivery of INH directly to every implementing site, alongside ARV. REULTS: We observed an increasing trend in TPT uptake between the pre-and-post intervention periods: 6% in fiscal year (FY) 2015, 7% in FY2016 and 12% in FY2017. Overall, the logistical changes in the LMIS to include INH in 2016 led to a 69% increase in TPT by the end of FY2017; this was statistically significant. CONCLUSION: Addressing logistical challenges to TPT implementation will ensure that the TB and HIV programmes can tackle the increasing burden of TB infection in people living with HIV. We recommended that the provider-to-client stage of TPT implementation be driven by the HIV programme and that cross-communication between the two programmes be improved.
Authors: S C Meribe; Y Adamu; E Adebayo-Abikoye; I Lawal; I Amazue-Ezeuko; N Okeji; I Okoye; P Agaba; R Nelson; E Lee; L Chittenden Journal: Public Health Action Date: 2020-06-21
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: Elizabeth H Lee; Kavitha Ganesan; Samoel A Khamadi; Stanley C Meribe; Dorothy Njeru; Yakubu Adamu; Fred Magala; Trevor A Crowell; Eniko Akom; Patricia Agaba; Priyanka Desai; Tiffany Hamm; Deydre Teyhen; Julie A Ake; Christina S Polyak; Douglas Shaffer; Fredrick Sawe; Patrick W Hickey Journal: Am J Trop Med Hyg Date: 2021-01 Impact factor: 3.707