Epidemiology Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Malawi Liverpool Wellcome Trust, Blantyre, Malawi.
Int J Tuberc Lung Dis. 2018 Apr 1;22(4):371-377. doi: 10.5588/ijtld.16.0836.
To reduce the risk of tuberculosis (TB) among individuals with human immunodeficiency virus (HIV) infection, the World Health Organization recommends at least 6 months of isoniazid preventive therapy (IPT). Completion of IPT remains a major challenge in resource-limited settings.
To evaluate predictors of IPT completion in individuals newly diagnosed with HIV.
Predictors of IPT completion among adults newly diagnosed with HIV in rural Malawi were evaluated using a multilevel logistic regression model.
Of 974 participants who screened negative for active TB and were started on IPT, 732 (75%) completed treatment. Only one IPT-eligible individual refused treatment. Participants who were aged <25 years (compared with those aged 45 years, adjusted OR [aOR] 0.33, 95%CI 0.18-0.60) and male (compared to non-pregnant females, aOR 0.57, 95%CI 0.37-0.88) had lower odds of IPT completion.
IPT provision at the time of initial HIV diagnosis was highly acceptable in rural Malawi; three quarters of those who initiated IPT successfully completed therapy. We observed lower odds of completion among males and among female participants aged <25 years. Additional efforts may be needed to ensure IPT completion among males and young females who have recently been diagnosed with HIV.
为降低人类免疫缺陷病毒（HIV）感染者发生结核病（TB）的风险，世界卫生组织建议至少进行 6 个月的异烟肼预防治疗（IPT）。在资源有限的环境中，完成 IPT 仍然是一项重大挑战。
评估新诊断出 HIV 的个体完成 IPT 的预测因素。
采用多水平逻辑回归模型评估马拉维农村地区新诊断出 HIV 的成年人中完成 IPT 的预测因素。
在筛查出无活动性结核病并开始接受 IPT 的 974 名参与者中，有 732 名（75%）完成了治疗。只有一名符合 IPT 条件的个体拒绝了治疗。年龄<25 岁的参与者（与年龄≥45 岁的参与者相比，调整后的 OR [aOR]0.33，95%CI0.18-0.60）和男性（与非妊娠女性相比，aOR0.57，95%CI0.37-0.88）完成 IPT 的可能性较低。
在马拉维农村，初始 HIV 诊断时提供 IPT 的接受度很高；接受 IPT 的人群中，有四分之三成功完成了治疗。我们观察到男性和年龄<25 岁的女性参与者完成的可能性较低。可能需要采取额外的措施来确保最近被诊断出 HIV 的男性和年轻女性完成 IPT。
