TY - JOUR
T1 - Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries
AU - Charles, M. Katherine
AU - Lindegren, Mary Lou
AU - Wester, C. William
AU - Blevins, Meridith
AU - Sterling, Timothy R.
AU - Dung, Nguyen Thi
AU - Dusingize, Jean Claude
AU - Avit-Edi, Divine
AU - Durier, Nicolas
AU - Castelnuovo, Barbara
AU - Nakigozi, Gertrude
AU - Cortes, Claudia P.
AU - Ballif, Marie
AU - Fenner, Lukas
AU - Ajayi, Samuel
AU - Anastos, Kathryn
AU - Bashi, Jules
AU - Bishai, William
AU - Boulle, Andrew
AU - Braitstein, Paula
AU - Carriquiry, Gabriela
AU - Carter, Jane E.
AU - Cegielski, Peter
AU - Chimbetete, Cleophas
AU - Davies, Mary Ann
AU - Diero, Lameck
AU - Duda, Stephany
AU - Egger, Matthias
AU - Eboua, Tanoh F.
AU - Gasser, Adrian
AU - Geng, Elvin
AU - Gnokori, Joachim Charles
AU - Hardwicke, Laura
AU - Hoffmann, Chris
AU - Huebner, Robin
AU - Kancheya, Nzali
AU - Kiertiburanakul, Sasisopin
AU - Kim, Peter
AU - Lameck, Diero
AU - Leroy, Valériane
AU - Lewden, Charlotte
AU - Mandalakas, Anna
AU - Maskew, Mhairi
AU - McKaig, Rosemary
AU - Mofenson, Lynne
AU - Mpoudi-Etame, Mireille
AU - Okwara, Benson
AU - Phiri, Sam
AU - Prasitsuebsai, Wasana
AU - Wehbe, Firas
AU - International epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration
N1 - Funding Information:
Timothy R. Sterling reports past grant support to Vanderbilt University from Pfizer, Bristol Myers Squibb and Virco. Timothy R. Sterling has acted as a consultant to Sanofi-Aventis, is a member of a Data Safety Monitoring Board for Otsuka, and receives royalties from UpToDate for textbook chapters on TB/HIV. All other authors declare that they have no competing interests. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.
Publisher Copyright:
© 2016 Charles et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - 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.
AB - 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.
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U2 - 10.1371/journal.pone.0153243
DO - 10.1371/journal.pone.0153243
M3 - Article
C2 - 27073928
AN - SCOPUS:84963770998
SN - 1932-6203
VL - 11
JO - PloS one
JF - PloS one
IS - 4
M1 - e0153243
ER -