IMPROVING IPT UPTAKE AND ADHERENCE IN NAIROBI COUNTY: A CASE STUDY IN EASTLANDS PUBLIC HOSPITALS

Abstract

Tuberculosis (TB) remains a global health concern, primarily affecting the lungs and posing a significant threat to people living with HIV (PLHIV). In 2016, the World Health Organization (WHO) reported TB as one of the top ten causes of death among PLHIV, with 1.4 million deaths worldwide, including four thousand PLHIV. The co-occurrence of TB and HIV has led to over ten million reported cases of TB globally, predominantly in regions with a high prevalence of HIV. This resurgence of TB presents a substantial challenge to public health.

The uptake of Isoniazid Preventive Therapy (IPT) as a strategy to reduce the incidence of TB has been suboptimal, especially in areas with a high burden of TB. In 2015, only one million PLHIV newly enrolled in HIV care were confirmed to have received IPT, indicating a low adoption rate. Notably, among the 16 countries with a high TB burden, IPT coverage was as low as 2%. Several factors contribute to this low uptake, including medication costs, insufficient human resources to ensure treatment completion, and supply chain issues. Additionally, there is a need for a shift in the management of patients and medical dispensing methods to streamline the process and alleviate the burden on both patients and healthcare workers. Continual monitoring remains a critical approach to managing TB cases globally