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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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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. |
format | Online Article Text |
id | pubmed-4830552 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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