Uptake of isoniazid preventive therapy and associated factors among eligible people living with HIV/AIDS in care at health facilities in Tororo District

Abstract

Introduction and Background: Uganda adopted the strategy of uptake of IPT among PLWHA. The aim of this was to reduce the risk of acquiring active TB among patients with latent TB infections. Despite various interventions, uptake of IPT in Uganda remains low, there is limited information available about the prevalence and factors associated with uptake of IPT among PLWHA in care at health facilities in Tororo district. The aim of this study was to determine the uptake of IPT and associated factors among PLWHA in care at health facilities in Tororo district. Methods: A mixed methods study design was conducted among PLWHA between July-August 2019 in Tororo district. To determine the prevalence and associated factors of uptake of IPT among PLWHA, an interview administered questionnaire was used to collect data among 436 respondents in the various health facilities. Key informants included expert clients and the health workers in the HIV/TB clinics. Key informant interview guide was used to collect data on the barriers and facilitators to uptake of IPT among PLWHA. Quantitative data were analysed using STATA version 14. Modified Poisson regression analysis, with robust standard errors was used to determine association between IPT uptake take and independent variables at 95% CI. Qualitative interviews were audio recorded, transcribed verbatim and analysed manually using content analysis approach. Results: The prevalence of IPT uptake among PLWHA was 61.2% (225/436). The individual factors associated with uptake of IPT included; being self-employed (APR 1.24, 95% CI, 1.10 - 1.41), having good knowledge on TB (APR 2.01, 95% CI, 1.08 - 3.71), being knowledgeable about eligibility for IPT (APR, 2.19 95% CI, 1.38 - 3.49) and disclosure of HIV status (APR, 2.52 95% CI, 1.24 - 5.13). Facilitators for IPT uptake included availability of IPT and screening services, knowledge of health workers on IPT, health education and counselling, health outcomes of clients on IPT, health worker supervision and organization of work, whereas the, barriers included supply of IPT to the health facilities; organization of work; increased workload at HIV clinics; drug related factors; and supervision of health workers. Conclusion: IPT uptake among PLWHA was high above the national coverage but below national target of 90%, this was attributed to good knowledge on TB and IPT eligibility, HIV status disclosure. Interventions designed should focus on client information on TB, IPT and disclosure.