Isoniazid preventive therapy completion between July-September 2019: A comparison across HIV differentiated service delivery models in Uganda

dc.contributor.authorLevicatus, Mugenyi
dc.contributor.authorProscovia, Mukonzo Namuwenge
dc.contributor.authorSimple, Ouma
dc.contributor.authorBaker, Bakashaba
dc.contributor.authorMastula, Nanfuka
dc.contributor.authorJennifer, Zech
dc.contributor.authorCollins, Agaba
dc.contributor.authorAndrew, Mijumbi Ojok
dc.contributor.authorFedress, Kaliba
dc.contributor.authorJohn, Bossa Kato
dc.contributor.authorRonald, Opito
dc.contributor.authorYunus, Miya
dc.contributor.authorCordelia, Katureebe
dc.contributor.authorYael, Hirsch-Moverman
dc.date.accessioned2024-03-13T00:16:16Z
dc.date.available2024-03-13T00:16:16Z
dc.date.issued2024-01-02
dc.descriptionPLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0296239en_US
dc.description.abstractBackground Tuberculosis (TB) remains the leading cause of death among people living with HIV (PLHIV). To prevent TB among PLHIV, the Ugandan national guidelines recommend Isoniazid Preventive Therapy (IPT) across differentiated service delivery (DSD) models, an effective way of delivering ART. DSD models include Community Drug Distribution Point (CDDP), Community Client-led ART Delivery (CCLAD), Facility-Based Individual Management (FBIM), Facility-Based Group (FBG), and Fast Track Drug Refill (FTDR). Little is known about the impact of delivering IPT through DSD. Methods We reviewed medical records of PLHIV who initiated IPT between June-September 2019 at TASO Soroti (TS), Katakwi Hospital (KH) and Soroti Regional Referral Hospital (SRRH). We defined IPT completion as completing a course of isoniazid within 6–9 months. We utilized a modified Poisson regression to compare IPT completion across DSD models and determine factors associated with IPT completion in each DSD model. Results Data from 2968 PLHIV were reviewed (SRRH: 50.2%, TS: 25.8%, KH: 24.0%); females: 60.7%; first-line ART: 91.7%; and Integrase Strand Transfer Inhibitor (INSTI)-based regimen: 61.9%. At IPT initiation, the median age and duration on ART were 41.5 (interquartile range [IQR]; 32.3–50.2) and 6.0 (IQR: 3.7–8.6) years, respectively. IPT completion overall was 92.8% (95%CI: 91.8–93.7%); highest in CDDP (98.1%, 95%CI: 95.0–99.3%) and lowest in FBG (85.8%, 95%CI: 79.0–90.7%). Compared to FBIM, IPT completion was significantly higher in CDDP (adjusted rate ratio [aRR] = 1.15, 95%CI: 1.09–1.22) and CCLAD (aRR = 1.09, 95% CI 1.02–1.16). In facility-based models, IPT completion differed between sites (p<0.001). IPT completion increased with age for FBIM and CCLAD and was lower among female participants in the CCLAD (aRR = 0.82, 95%CI 0.67–0.97). Conclusion IPT completion was high overall but highest in community-based models. Our findings provide evidence that supports integration of IPT within DSD models for ART delivery in Uganda and similar settings.en_US
dc.description.sponsorshipThis project was funded by the Ugandan Ministry of Health and by grant # OPP1152764 from the Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.en_US
dc.identifier.citationMugenyi L, Namuwenge PM, Ouma S, Bakashaba B, Nanfuka M, Zech J, et al. (2024) Isoniazid preventive therapy completion between July-September 2019: A comparison across HIV differentiated service delivery models in Uganda. PLoS ONE 19(1): e0296239. https://doi.org/ 10.1371/journal.pone.0296239en_US
dc.identifier.urihttps://ir.sun.ac.ug//handle/123456789/93
dc.language.isoenen_US
dc.publisherPLOS One Publishersen_US
dc.subjectDSD, Differentiated Services Delivery (model); CCLAD, Community Client-Led ART Delivery (model); CDDP, Community Drug Distribution Point (model); FTDR, Fast Track Drug Refill (model); FBG, Facility Based Group (model); TPT, TB Preventive Therapy; HIV, Human Immunodeficiency Virus; IQR, Interquartile rangeen_US
dc.titleIsoniazid preventive therapy completion between July-September 2019: A comparison across HIV differentiated service delivery models in Ugandaen_US
dc.typeArticleen_US

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