U.S. Centers for Disease Control and Prevention, Harare, Zimbabwe.
ICAP at Columbia University, Harare, Zimbabwe.
Int J STD AIDS. 2024 Jul;35(8):593-599. doi: 10.1177/09564624241239186. Epub 2024 Mar 22.
Tuberculosis remains the leading cause of death by an infectious disease among people living with HIV (PLHIV). TB Preventive Treatment (TPT) is a cost-effective intervention known to reduce morbidity and mortality. We used data from ZIMPHIA 2020 to assess TPT uptake and factors associated with its use.
ZIMPHIA a cross-sectional household survey, estimated HIV treatment outcomes among PLHIV aged ≥15 years. Randomly selected participants provided demographic and clinical information. We applied multivariable logistic regression models using survey weights. Variances were estimated via the Jackknife series to determine factors associated with TPT uptake.
The sample of 2419 PLHIV ≥15 years had 65% females, 44% had no primary education, and 29% lived in urban centers. Overall, 38% had ever taken TPT, including 15% currently taking TPT. Controlling for other variables, those screened for TB at last HIV-related visit, those who visited a TB clinic in the previous 12 months, and those who had HIV viral load suppression were more likely to take TPT.
The findings show suboptimal TPT coverage among PLHIV. There is a need for targeted interventions and policies to address the barriers to TPT uptake, to reduce TB morbidity and mortality among PLHIV.
结核病仍然是导致 HIV 感染者(PLHIV)死亡的主要传染病。结核预防治疗(TPT)是一种已被证实可降低发病率和死亡率的具有成本效益的干预措施。我们使用来自 ZIMPHIA 2020 的数据评估 TPT 的采用情况以及与 TPT 使用相关的因素。
ZIMPHIA 是一项横断面家庭调查,估计了≥15 岁的 PLHIV 的 HIV 治疗结局。随机选择的参与者提供了人口统计学和临床信息。我们使用调查权重应用多变量逻辑回归模型。通过 Jackknife 系列估计方差,以确定与 TPT 采用相关的因素。
2419 名≥15 岁的 PLHIV 样本中,65%为女性,44%没有小学教育,29%居住在城市中心。总体而言,38%的人曾经接受过 TPT,其中 15%目前正在接受 TPT。在控制其他变量的情况下,在上一次 HIV 相关就诊时接受过结核病筛查、在过去 12 个月内去过结核病诊所、以及 HIV 病毒载量得到抑制的人更有可能接受 TPT。
研究结果表明 PLHIV 中 TPT 的覆盖率不理想。需要采取有针对性的干预措施和政策,以解决 TPT 采用的障碍,降低 PLHIV 的结核病发病率和死亡率。