Factors influencing isoniazid preventive therapy uptake among children living with HIV in Mwanza region in Tanzania.

Abstract

Introduction: WHO recommended the expanded delivery of isoniazid preventive therapy (IPT) to reach those at greatest risk for progressing to TB disease, especially people living with HIV, to receive IPT for at least 6 months as part of comprehensive HIV care. However, IPT enrolment and completion have remained low, especially in low-income countries with a high TB burden Objective: To determine the factors influencing IPT uptake among children living with HIV aged 1 to 10 years at health care and treatment clinics (CTC) in the Mwanza region. Methods: Quantitative and qualitative approaches in data collection were employed to determine factors influencing IPT uptake among children living with HIV. The study was done in seven districts of Mwanza. In quantitative arm, the proportion of 415 CLHIV (1 to 10years) for each health facility was obtained and stratified. Systematic selection was applied to get participants. Structured questionnaire was used to collect the data. In qualitative arm, 14 health workers were enrolled into this study and the selection to get them was done purposely. Analysis for data collected using quantitative component was done using STATA whereas thematic framework analysis was used to analyze data collected using qualitative component Results: The Uptake of isoniazid preventive therapy among children living with HIV in Mwanza was 91%. The study revealed that caregivers engaged in employment (a PR 1.1; 95% CI 1.00-1.13; P-value 0.046), children not on ART (a PR 0.9; 95%CI 0.88-0.95; P-value 0.000) and visiting clinic every month (a PR 1.1; 95%CI 1.04-1.14; P-value 0.000) were significantly associated with IPT uptake. In qualitative approach, availability of training, implementing partners and drug effectiveness were the facilitators of IPT uptake whereas pill burden and IPT shortage were the barriers of IPT uptake Conclusion and recommendations: This study has demonstrated high IPT uptake among children living with HIV in relation to the set global uptake target, this indicate the improvement in implementation of IPT services delivery compared to the low IPT prevalence reported in the past from Ministry of Health Reports. More efforts should be put in place to unemployed caregivers by empowering them.