Adherence, tolerability, and outcome after 36 months of isoniazid-preventive therapy in 2 rural clinics of Swaziland: A prospective observational feasibility study.

Détails

Ressource 1Télécharger: 2017_Medicine_IPT_Swaziland.pdf (184.13 [Ko])
Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_8267A816FDAB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Adherence, tolerability, and outcome after 36 months of isoniazid-preventive therapy in 2 rural clinics of Swaziland: A prospective observational feasibility study.
Périodique
Medicine
Auteur(s)
Mueller Y., Mpala Q., Kerschberger B., Rusch B., Mchunu G., Mazibuko S., Bonnet M.
ISSN
1536-5964 (Electronic)
ISSN-L
0025-7974
Statut éditorial
Publié
Date de publication
09/2017
Peer-reviewed
Oui
Volume
96
Numéro
35
Pages
e7740
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Résumé
Although efficacy of 36 months isoniazid preventive therapy (IPT) among HIV-positive individuals has been proven in trial settings, outcome, tolerance, and adherence have rarely been evaluated in real-life settings.This is a prospective observational cohort study conducted in 2 primary care rural clinics in Swaziland.After negative tuberculosis symptom screening, patients either with the positive tuberculin skin test (TST) or after tuberculosis treatment were initiated on IPT for 144 weeks. In addition to routine clinic visits, adherence was assessed every semester.Of 288 eligible patients, 2 patients never started IPT (1 refusal, 1 contraindication), and 253 (87.8%), 234 (81.3%), and 228 (79.2%) were still on IPT after 48, 96, and 144 weeks, respectively (chiP = .01). Of 41 patients who interrupted IPT before 144 weeks, 21 defaulted (of which 17 also defaulted HIV care); 16 stopped because of adverse drug reactions; 2 were discontinued by clinicians' mistake and 1 because of TB symptoms. Five patients (1.7%) died of causes not related to IPT, 5 (1.7%) developed TB of which 2 were isoniazid-resistant, and 9 (3.1%) were transferred to another clinic. As an indicator of adherence, isoniazid could be detected in the urine during 86.3% (302/350) and 73.6% (248/337) of patient visits in the 2 clinics, respectively (chiP < .001).The routine implementation of IPT 36 months was feasible and good patient outcomes were achieved, with low TB incidence, good tolerance, and sustained adherence.

Mots-clé
Adult, Antitubercular Agents/administration & dosage, Antitubercular Agents/therapeutic use, Cohort Studies, Drug Administration Schedule, Feasibility Studies, Female, HIV Infections, Humans, Isoniazid/administration & dosage, Isoniazid/therapeutic use, Male, Medication Adherence, Middle Aged, Prospective Studies, Rural Health Services, Swaziland, Treatment Outcome, Tuberculosis, Pulmonary/mortality, Tuberculosis, Pulmonary/prevention & control
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/01/2018 13:18
Dernière modification de la notice
08/05/2019 21:13
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