Effect of Isoniazid Preventive Therapy on Tuberculosis Prevalence among HIV Patients Attending Bahati Comprehensive Care Centre, Nairobi, Kenya

Abstract

Introduction Worldwide tuberculosis was top ten cause of death alongside, Human Immunodeficiency Virus (HIV) in 2018; 10.0 million people became ill with tuberculosis with 1.2 million deaths occurring among HIV negative people while an additional 251,000 were HIV positive. Isoniazid preventive therapy (IPT), intensified case finding, and infection control have been widely recommended to reduce the burden of TB in people living with Human Immunodeficiency Virus (PLHIV). IPT works synergistically but independently of antiretroviral therapy (ART) to reduce the morbidity, mortality and incidence of tuberculosis among PLHIV, but its uptake has been slow in most developing countries. Objective: This study sought to find the effect of isoniazid preventive therapy on prevalence of tuberculosis among HIV patients attending Bahati comprehensive care centre. Materials and Methods A retrospective cohort study was conducted over a seven month period among consented 346 people living with Human Immunodeficiency Virus (HIV) residing in Makadara Nairobi County, attending Bahati comprehensive care centre with signs and symptoms of TB. Sampled sputa from the participants were analyzed for detection of Mycobacterium tuberculosis by GeneXpert MTB/RIF assay and culture by BACTEC MGIT 960. Socio demographic and laboratory data was collected and the data was analyzed using SPSS version 20.0. Results Of the three hundred and forty six sputa sampled and analyzed, 10(6.5%) and 67(35.1%) IPT and non-IPT patients had Mycobacterium tuberculosis detected respectively; P=0.001. On the other hand 57(18.2%) and 20(60.6%) new and retreatment patients had Mycobacterium tuberculosis detected respectively. Conclusion Isoniazid preventive therapy is protective towards progressing to active tuberculosis disease and symptomatic previously treated Tuberculosis (TB) patients are more likely to have confirmed TB disease. There was no significant association between prevalence of tuberculosis, age and gender of the patients