Ayele Asnakew Achaw, Asrade Atnafie Seyfe, Balcha Demis Driba, Weredekal Asegedech Tsegaw, Woldegiorgis Birhanu Alemayehu, Wotte Mulgeta Melaku, Gebresillasie Begashaw Melaku
Department of Clinical Pharmacy.
Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Patient Prefer Adherence. 2017 Apr 10;11:743-749. doi: 10.2147/PPA.S131314. eCollection 2017.
This study aimed to assess self-reported adherence and associated factors to isoniazid preventive therapy (IPT) for latent tuberculosis among people living with HIV/AIDS (PLWHA) at health centers in Gondar town, North West Ethiopia.
An institution-based prospective cross-sectional study was conducted from March 10 to June 11, 2016. A total of 154 eligible participants were included in the study, using the simple random sampling method, from the available four health centers and one teaching referral hospital that provided antiretroviral therapy (ART) for HIV/AIDS patients. Adherence was measured by self-report of isoniazid (INH) tablets taken for the preceding 7 days. Participants were recruited through in-depth interviews. The collected data were entered and analyzed using the statistical packages for social sciences (SPSS) version 20.
The adherence level to IPT was 90.3% for the last 7 days of the study. ART was initiated for 84.4%, and all of them were on a first-line regimen. Isoniazid-related side effects were reported by 48 (31.2%) participants, of which the most commonly identified were abdominal pain, vomiting, skin rash, jaundice, and numbness. Only 3 (2%) participants discontinued from the study. In the bivariate logistic regression analysis, respondents who had received an explanation about IPT were 83% times more likely to be adherent compared to those who had not received it (95% CI, AOR: 0.266 [0.23-3.127]). Respondents who had taken IPT for ≥5 months were more likely to be adherent than those who had taken it for 1-2 months [95% CI, COR: 1.484]. On the other hand, respondents who experienced side effects were 36% less likely to be adherent compared to those who did not experience any.
The level of adherence to IPT among PLWHA was high. Among the predictors reported, carelessness and/or forgetfulness, side effects, and absence from home were the major factors identified for being nonadherent. Health professionals and the Ministry of Health should design and deliver appropriate health education tips and messages. Moreover, counseling of patients who are in their first 2 months of therapy should be strengthened further.
本研究旨在评估埃塞俄比亚西北部贡德尔镇各健康中心感染艾滋病毒/艾滋病（PLWHA）的患者对异烟肼预防性治疗（IPT）用于潜伏性结核病的自我报告依从性及相关因素。
2016年3月10日至6月11日进行了一项基于机构的前瞻性横断面研究。采用简单随机抽样方法，从为艾滋病毒/艾滋病患者提供抗逆转录病毒治疗（ART）的四个健康中心和一家教学转诊医院中，共纳入154名符合条件的参与者。依从性通过自我报告前7天服用异烟肼（INH）片剂的情况来衡量。通过深入访谈招募参与者。收集的数据使用社会科学统计软件包（SPSS）20版进行录入和分析。
在研究的最后7天，IPT的依从率为90.3%。84.4%的患者开始接受ART治疗，且均采用一线治疗方案。48名（31.2%）参与者报告了与异烟肼相关的副作用，其中最常见的是腹痛、呕吐、皮疹、黄疸和麻木。只有3名（2%）参与者退出研究。在双变量逻辑回归分析中，接受过IPT解释的受访者比未接受解释的受访者依从的可能性高83倍（95%置信区间，调整后比值比：0.266[0.23 - 3.127]）。接受IPT治疗≥5个月的受访者比接受治疗1 - 2个月的受访者更有可能依从[95%置信区间，校正比值比：1.484]。另一方面，出现副作用的受访者比未出现任何副作用的受访者依从的可能性低36%。
PLWHA对IPT的依从水平较高。在所报告的预测因素中，粗心和/或遗忘、副作用以及离家是确定的不依从的主要因素。卫生专业人员和卫生部应设计并提供适当的健康教育提示和信息。此外，应进一步加强对治疗前两个月患者的咨询。
