Taking tuberculosis preventive therapy implementation to national scale: the Nigerian PEPFAR Program experience

Background: Tuberculosis (TB) preventive therapy (TPT), including isoniazid preventive therapy (IPT), has been implemented within the Nigerian human immunodeficiency virus (HIV) programme since 2014. However, drug procurement and logistic support has remained the responsibility of the National Tuber...

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Bibliographic Details
Published in:	Public health action Vol. 10; no. 1; pp. 7 - 10
Main Authors:	Odume, B., Meribe, S. C., Odusote, T., Ifunanya, M., Debem, H., Amazue-Ezeuko, I., Ogbanufe, O., Adamu, Y., Onotu, D.
Format:	Journal Article
Language:	English
Published:	France International Union Against Tuberculosis and Lung Disease 21-03-2020
Subjects:	Human Immunodeficiency Virus isoniazid preventive therapy Original people living with HIV Tb Preventive Therapy Tuberculosis human immunodeficiency virus isoniazid preventive therapy people living with HIV TB preventive therapy tuberculosis
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Summary:	Background: Tuberculosis (TB) preventive therapy (TPT), including isoniazid preventive therapy (IPT), has been implemented within the Nigerian human immunodeficiency virus (HIV) programme since 2014. However, drug procurement and logistic support has remained the responsibility of the National Tuberculosis and Leprosy Control Programme. The US President's Emergency Plan for AIDS Relief-Nigeria (PEPFAR Nigeria) reviewed the key bottlenecks to TPT implementation in 2016.Method: The logistics of delivery of isoniazid (INH) were integrated with the antiretroviral (ARV) logistics management and information system (LMIS). Drug order and requisition forms at the facility level were revised to include INH, along with training on appropriate quantification and requisition of INH with ARVs. Support was provided for last mile delivery of INH directly to every implementing site, alongside ARV.Reults: We observed an increasing trend in TPT uptake between the pre-and-post intervention periods: 6% in fiscal year (FY) 2015, 7% in FY2016 and 12% in FY2017. Overall, the logistical changes in the LMIS to include INH in 2016 led to a 69% increase in TPT by the end of FY2017; this was statistically significant.Conclusion: Addressing logistical challenges to TPT implementation will ensure that the TB and HIV programmes can tackle the increasing burden of TB infection in people living with HIV. We recommended that the provider-to-client stage of TPT implementation be driven by the HIV programme and that cross-communication between the two programmes be improved.
Bibliography:	2220-8372(20200321)10:1L.7;1- ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 BO and SCM contributed equally to this manuscript.
ISSN:	2220-8372 2220-8372
DOI:	10.5588/pha.19.0033