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Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe

As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed...

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Autores principales: Msukwa, Martin K., Mapingure, Munyaradzi P., Zech, Jennifer M., Masvawure, Tsitsi B., Mantell, Joanne E., Musuka, Godfrey, Apollo, Tsitsi, Boccanera, Rodrigo, Chingombe, Innocent, Gwanzura, Clorata, Howard, Andrea A., Rabkin, Miriam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775984/
https://www.ncbi.nlm.nih.gov/pubmed/35052280
http://dx.doi.org/10.3390/healthcare10010116
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author Msukwa, Martin K.
Mapingure, Munyaradzi P.
Zech, Jennifer M.
Masvawure, Tsitsi B.
Mantell, Joanne E.
Musuka, Godfrey
Apollo, Tsitsi
Boccanera, Rodrigo
Chingombe, Innocent
Gwanzura, Clorata
Howard, Andrea A.
Rabkin, Miriam
author_facet Msukwa, Martin K.
Mapingure, Munyaradzi P.
Zech, Jennifer M.
Masvawure, Tsitsi B.
Mantell, Joanne E.
Musuka, Godfrey
Apollo, Tsitsi
Boccanera, Rodrigo
Chingombe, Innocent
Gwanzura, Clorata
Howard, Andrea A.
Rabkin, Miriam
author_sort Msukwa, Martin K.
collection PubMed
description As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed a study to assess the feasibility and acceptability of integrating TPT into CARGs among key stakeholders, including CARG members, in Zimbabwe. We conducted 45 key informant interviews (KII) with policy makers, implementers, and CARG leaders; 16 focus group discussions (FGD) with 136 PLHIV in CARGs; and structured observations of 8 CARG meetings. KII and FGD were conducted in English and Shona. CARG observations were conducted using a structured checklist and time-motion data capture. Ninety six percent of participants supported TPT integration into CARGs and preferred multi-month TPT dispensing aligned with ART dispensing schedules. Participants noted that the existing CARG support systems could be used for TB symptom screening and TPT adherence monitoring/support. Other perceived advantages included convenience for PLHIV and decreased health facility provider workloads. Participants expressed concerns about possible medication stockouts and limited knowledge about TPT among CARG leaders but were confident that CARGs could effectively provide community-based TPT education, adherence monitoring/support, and TB symptom screening provided that CARG leaders received appropriate training and supervision. These results are consistent with findings from pilot projects in other African countries that are scaling up both differentiated service delivery for HIV and TPT and suggest that designing contextually appropriate approaches to integrating TPT into less-intensive HIV treatment models is an effective way to reach people who are established on ART but who may have missed out on access to TPT.
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spelling pubmed-87759842022-01-21 Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe Msukwa, Martin K. Mapingure, Munyaradzi P. Zech, Jennifer M. Masvawure, Tsitsi B. Mantell, Joanne E. Musuka, Godfrey Apollo, Tsitsi Boccanera, Rodrigo Chingombe, Innocent Gwanzura, Clorata Howard, Andrea A. Rabkin, Miriam Healthcare (Basel) Article As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed a study to assess the feasibility and acceptability of integrating TPT into CARGs among key stakeholders, including CARG members, in Zimbabwe. We conducted 45 key informant interviews (KII) with policy makers, implementers, and CARG leaders; 16 focus group discussions (FGD) with 136 PLHIV in CARGs; and structured observations of 8 CARG meetings. KII and FGD were conducted in English and Shona. CARG observations were conducted using a structured checklist and time-motion data capture. Ninety six percent of participants supported TPT integration into CARGs and preferred multi-month TPT dispensing aligned with ART dispensing schedules. Participants noted that the existing CARG support systems could be used for TB symptom screening and TPT adherence monitoring/support. Other perceived advantages included convenience for PLHIV and decreased health facility provider workloads. Participants expressed concerns about possible medication stockouts and limited knowledge about TPT among CARG leaders but were confident that CARGs could effectively provide community-based TPT education, adherence monitoring/support, and TB symptom screening provided that CARG leaders received appropriate training and supervision. These results are consistent with findings from pilot projects in other African countries that are scaling up both differentiated service delivery for HIV and TPT and suggest that designing contextually appropriate approaches to integrating TPT into less-intensive HIV treatment models is an effective way to reach people who are established on ART but who may have missed out on access to TPT. MDPI 2022-01-07 /pmc/articles/PMC8775984/ /pubmed/35052280 http://dx.doi.org/10.3390/healthcare10010116 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Msukwa, Martin K.
Mapingure, Munyaradzi P.
Zech, Jennifer M.
Masvawure, Tsitsi B.
Mantell, Joanne E.
Musuka, Godfrey
Apollo, Tsitsi
Boccanera, Rodrigo
Chingombe, Innocent
Gwanzura, Clorata
Howard, Andrea A.
Rabkin, Miriam
Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe
title Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe
title_full Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe
title_fullStr Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe
title_full_unstemmed Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe
title_short Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe
title_sort acceptability of community-based tuberculosis preventive treatment for people living with hiv in zimbabwe
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775984/
https://www.ncbi.nlm.nih.gov/pubmed/35052280
http://dx.doi.org/10.3390/healthcare10010116
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