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Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries

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 im...

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Autores principales: Charles, M. Katherine, Lindegren, Mary Lou, Wester, C. William, Blevins, Meridith, Sterling, Timothy R., Dung, Nguyen Thi, Dusingize, Jean Claude, Avit-Edi, Divine, Durier, Nicolas, Castelnuovo, Barbara, Nakigozi, Gertrude, Cortes, Claudia P., Ballif, Marie, Fenner, Lukas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830552/
https://www.ncbi.nlm.nih.gov/pubmed/27073928
http://dx.doi.org/10.1371/journal.pone.0153243
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author Charles, M. Katherine
Lindegren, Mary Lou
Wester, C. William
Blevins, Meridith
Sterling, Timothy R.
Dung, Nguyen Thi
Dusingize, Jean Claude
Avit-Edi, Divine
Durier, Nicolas
Castelnuovo, Barbara
Nakigozi, Gertrude
Cortes, Claudia P.
Ballif, Marie
Fenner, Lukas
author_facet Charles, M. Katherine
Lindegren, Mary Lou
Wester, C. William
Blevins, Meridith
Sterling, Timothy R.
Dung, Nguyen Thi
Dusingize, Jean Claude
Avit-Edi, Divine
Durier, Nicolas
Castelnuovo, Barbara
Nakigozi, Gertrude
Cortes, Claudia P.
Ballif, Marie
Fenner, Lukas
author_sort Charles, M. Katherine
collection PubMed
description 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% non-integrated; 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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spelling pubmed-48305522016-04-22 Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries Charles, M. Katherine Lindegren, Mary Lou Wester, C. William Blevins, Meridith Sterling, Timothy R. Dung, Nguyen Thi Dusingize, Jean Claude Avit-Edi, Divine Durier, Nicolas Castelnuovo, Barbara Nakigozi, Gertrude Cortes, Claudia P. Ballif, Marie Fenner, Lukas PLoS One Research Article 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% non-integrated; 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. Public Library of Science 2016-04-13 /pmc/articles/PMC4830552/ /pubmed/27073928 http://dx.doi.org/10.1371/journal.pone.0153243 Text en © 2016 Charles et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Charles, M. Katherine
Lindegren, Mary Lou
Wester, C. William
Blevins, Meridith
Sterling, Timothy R.
Dung, Nguyen Thi
Dusingize, Jean Claude
Avit-Edi, Divine
Durier, Nicolas
Castelnuovo, Barbara
Nakigozi, Gertrude
Cortes, Claudia P.
Ballif, Marie
Fenner, Lukas
Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries
title Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries
title_full Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries
title_fullStr Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries
title_full_unstemmed Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries
title_short Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries
title_sort implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("three i's") and hiv-tuberculosis service integration in lower income countries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830552/
https://www.ncbi.nlm.nih.gov/pubmed/27073928
http://dx.doi.org/10.1371/journal.pone.0153243
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