Apstrakt
Introduction: Tuberculosis (TB) accounts for the death of more than a quarter of people living with HIV. One of the strategies to reduce the incidence of TB among HIV patients is the use of Isoniazid Preventive Therapy (IPT). However, IPT implementation has been low globally. This study aims to identify the challenges facing IPT implementation and strategies to overcoming them.
Materials and Methods: The study involved the use of quantitative and qualitative methods. A cross sectional study design was used to identify the status and challenges confronting IPT implementation. Key informant interviews were conducted to identify strategies to overcome identified challenges.
Results: Inadequate human resources for health and work load were challenges confronting implementation of IPT identified by 91% and 80% of the respondents respectively. Other challenges
include; fear of poor adherence, fear of INH toxicity and fear of patients developing resistance to INH. Employment and training of health care workers at the HIV clinic were suggested strategies to overcome current challenges facing the implementation of IPT for PLHIV.
Conclusions: Inadequate human resources is the leading challenge confronting IPT implementation in our setting. Employment of more health care workers, task shifting and the use of volunteers will help to improve access to IPT by PLHIV.
Keywords: Current status, challenges, implementation, IPT, PLHIV
Résumé
Contexte: La tuberculose (TB) explique la mort de plus d’un quart des personnes vivant avec le VIH. L’une des stratégies pour réduire l’incidence de la tuberculose chez les patients infectés par le VIH est l’utilisation de la thérapie préventive à l’isoniazide (TPI). Cependant, la mise en œuvre du TPI a été faible au niveau mondial. Cette étude vise à identifier les défis auxquels est confrontée la mise en œuvre du TPI et les stratégies pour les surmonter.
Matériels et méthodes: L’étude a impliqué l’utilisation de méthodes quantitatives et qualitatives. Un plan d’étude transversal a été utilisé pour identifier le statut et les défis auxquels est confrontée la mise en œuvre du TPI. Des entrevues avec des informateurs clés ont été menées afin d’identifier des stratégies pour surmonter les difficultés identifiées.
Résultats: Des ressources humaines inadéquates pour la santé et la charge de travail ont été des défis auxquels ont été confrontés la mise en œuvre du TPI, identifiés respectivement par 91% et 80% des répondants. D’autres défis incluent; la crainte d’une mauvaise adhérence, la crainte de la toxicité de l’INH et la crainte que les patients développent une résistance à l’INH. L’emploi et la formation des agents de la santé à la clinique VIH ont été des stratégies suggérées pour surmonter les défis actuels liés à la mise en œuvre du TPI pour les PVVIH.
Conclusions: L’insuffisance des ressources humaines est le principal défi auquel est confrontée la mise en œuvre du TPI dans notre environnement. L’emploi d’un plus grand nombre d’agents de la santé, le transfert des tâches et le recours aux bénévoles aideront les PVVIH à accéder plus facilement au TPI.
Mots-clés: Situation actuelle, Défis, Mise en œuvre, TPI, PVVIH
Correspondence: Dr. O.S. Olajide, Clinical Services Department, APIN Public Health Initiatives, Ibadan Regional Office, Oyo State, Nigeria, E-mail: oolajide2apin.org.ng
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