Correlates of adherence and utilization of Isoniazid preventive therapy in HIV patients

Amaç: Latent tüberküloz enfeksiyonu olan bireylere aktif hastalığın ilerlemesini önlemek için İzoniyazid (INH) profilaksisi verilir. Uyumsuzluk ile ilişkili faktörleri anlamak profilaksi başarısı için önemlidir. Bu çalışmada HIV pozitif hastalarda uyuma ilişkin faktörleri tespit etmek, hastaların ve sağlık hizmeti sunucularının görüşlerini keşfetmek hedeflendi.Yöntemler: Çalışmaya Yekatit 12 hastanesinde takip edilen uygun 403 rastgele seçilmiş HIV pozitif ve INH profilaksisi alan hasta dahil edildi. Uyum, hastaların son 3, 7 ve 30 günde aldıkları INH tabletlerini öz-bildirim metodu ile bildirmeleri ile ölçüldü. Hastalar ve sağlık profesyonelleriyle derinlemesine görüşmeler yapıldı.Bulgular: INH uyumu son yedi gün için % 94 idi. INH ilgili ortak yan etkiler 142 katılımcı (% 35,2) tarafından bildirildi ve sadece 53 (% 13,2) olguda tedavi kesildi. Sarılık, deri döküntüsü ve nöbet gelişmeyen hastalarda sırasıyla 104, 7,7 ve 34,8 [% 95 Güven Aralığı (18,7-582,6), (2,6-22,9) ve (4,4-272,6)] kat fazla uyum olduğu saptandı.Sonuç: Yekatit 12 hastanesinde INH uyum sıklığı diğer yerel ve Afrika çalışmalarına göre daha iyidir ve kötü uyum nedenleri içinde ciddi sarılık görülmesi, deri döküntüsü ve havale gelişimi bulunmaktadır. Kapsamlı bakım ve destek, sürdürülebilir ilaç temini ve yan etkilerin değerlendirilmesi önerilir

Objective: Isoniazid (INH) is given to individuals with latent infection of tuberculosis in order to prevent progression to active disease. It is important to understand factors associated with non-adherence to prophylactic Isoniazid. This study aimed to identify correlates of adherence and utilization of Isoniazid in HIV positive patients and to explore the opinions of patients and health care providers.Methods: Participants eligible for the study were 403 randomly selected HIV positive individuals taking INH on follow up in Yekatit 12 hospital. Adherence was measured by self-report of INH tablets taken for past 3, 7 and 30 days. In depth interview was also conducted on recruited patients and health professionals.Results: Adherence to INH was 94% for last 7 days. INH related common side effects were reported by 142 participants (35.2%) and only 53 (13.2%) discontinued. The odds of adherence was 104, 7.7 and 34.8 [95% Confidence Interval (18.7, 582.6), (2.6, 22.9) and (4.4, 272.6)] times higher among those patients who did not have jaundice, skin rash and seizure compared to those who developed, respectively.Conclusion: The prevalence of adherence to INH in Yekatit 12 hospital was better than other local and African studies and the reasons for poor adherence was strongly associated with occurrence of jaundice, skin rash and seizure. Comprehensive care and support, sustainable drug supply and evaluation of side effects are recommended. J Microbiol Infect Dis 2015;5(2): 45-50Key words: Tuberculosis; HIV; adherence, Isoniazid, preventive therapy, side effects

Keywords:

Tuberculosis; HIV; adherence, Isoniazid preventive therapy, side effects,

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