Dotting the Three I's for collaborative TB-HIV activities: evaluation of a pilot programme in Kathmandu, Nepal.
Setting:The three government tertiary care hospitals providing care for people living with the human immunodeficiency virus (PLHIV) in Kathmandu, Nepal.Objectives:To assess 1) the screening cascades for intensified case finding for tuberculosis (TB), 2) isoniazid preventive therapy (IPT), including demographic and clinical factors associated with treatment interruption, and 3) TB infection control (IC) in the health facilities.Design:A cross-sectional study of new PLHIV enrolled from January 2012 to December 2014.Results:Among 572 registered PLHIV, 91% were on antiretroviral therapy. Of those registered, 561 (98%) were screened for TB and 73 (13%) were diagnosed with TB (17 [25%] sputum smear-positive, 17 [25%] smear-negative and 35 [51%] extra-pulmonary). Among the 488 (87%) PLHIV without active TB, 157 (32%) were initiated on IPT, of whom 136 (87%) completed treatment and 17 (11%) interrupted treatment. Those who experienced adverse events were 12 times more likely to interrupt IPT. TB IC showed gaps in personal control measures and supporting structures and policies.Conclusion:The implementation of the Three I's for collaborative TB-HIV activities in pilot sites in Nepal was successful and should be scaled up.
National Tuberculosis Centre, Thimi, Bhaktapur, Nepal.
S K
SK
Sah
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
S K
SK
Sahu
National Tuberculosis Centre, Thimi, Bhaktapur, Nepal.
B
B
Lamichhane
South Asian Association for Regional Cooperation Tuberculosis and HIV/AIDS Centre, Thimi, Bhaktapur, Nepal.
G K
GK
Bhatta
National Centre for AIDS and STD Control, Kathmandu, Nepal.
K B
KB
Bhandari
Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya.
P
P
Owiti
Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.
S S
SS
Majumdar
Nepal; human immunodeficiency virus; infection control; intensified case finding; isoniazid preventive therapy; tuberculosis
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