Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries

M. Katherine Charles, Mary Lou Lindegren, C. William Wester, Meridith Blevins, Timothy R. Sterling, Nguyen Thi Dung, Jean Claude Dusingize, Divine Avit-Edi, Nicolas Durier, Barbara Castelnuovo, Gertrude Nakigozi, Claudia P. Cortes, Marie Ballif, Lukas Fenner, Samuel Ajayi, Kathryn Anastos, Jules Bashi, William Bishai, Andrew Boulle, Paula BraitsteinGabriela Carriquiry, Jane E. Carter, Peter Cegielski, Cleophas Chimbetete, Mary Ann Davies, Lameck Diero, Stephany Duda, Matthias Egger, Tanoh F. Eboua, Adrian Gasser, Elvin Geng, Joachim Charles Gnokori, Laura Hardwicke, Chris Hoffmann, Robin Huebner, Nzali Kancheya, Sasisopin Kiertiburanakul, Peter Kim, Diero Lameck, Valériane Leroy, Charlotte Lewden, Anna Mandalakas, Mhairi Maskew, Rosemary McKaig, Lynne Mofenson, Mireille Mpoudi-Etame, Benson Okwara, Sam Phiri, Wasana Prasitsuebsai, Firas Wehbe, International epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration

    Research output: Contribution to journalArticlepeer-review

    14 Scopus citations

    Abstract

    Setting: World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), and infection control ("Three I's") for TB prevention and control among persons living with HIV. Objective: To assess the implementation of the "Three I's" of TB-control at HIV treatment sites in lower income countries. Design: Survey conducted between March-July, 2012 at 47 sites in 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central and South America, 5 (10%) Central Africa, 8 (17%) East Africa, 14 (30%) Southern Africa, and 7 (15%) West Africa. Results: ICF using symptom-based screening was performed at 38% of sites; 45% of sites used symptom-screening plus additional diagnostics. IPT at enrollment or ART initiation was implemented in only 17% of sites, with 9% of sites providing IPT to tuberculin-skin-test positive patients. Infection control measures varied: 62% of sites separated smear-positive patients, and healthcare workers used masks at 57% of sites. Only 12 (26%) sites integrated HIV-TB services. Integration was not associated with implementation of TB prevention measures except for IPT provision at enrollment (42% integrated vs. 9% nonintegrated; p = 0.03). Conclusions: Implementation of TB screening, IPT provision, and infection control measures was low and variable across regional HIV treatment sites, regardless of integration status.

    Original languageEnglish (US)
    Article numbere0153243
    JournalPloS one
    Volume11
    Issue number4
    DOIs
    StatePublished - Apr 1 2016

    ASJC Scopus subject areas

    • Biochemistry, Genetics and Molecular Biology(all)
    • Agricultural and Biological Sciences(all)
    • General

    Fingerprint Dive into the research topics of 'Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries'. Together they form a unique fingerprint.

    Cite this