Catrianiningsih Dani, Sanjaya Guardian Yoki, Chan Geoff, Nababan Betty Weri Yolanda, Triasih Rina, Intani Desthi Diah, Rahayu Endang Sri
Center for Tropical Medicine, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
Trop Med Infect Dis. 2025 Jan 20;10(1):28. doi: 10.3390/tropicalmed10010028.
Tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) has been recommended by Indonesia's National TB Program since 2014 but has seen limited implementation. This study describes TB screening and TPT initiation from 2019 to 2022 among eight healthcare facilities supported by the Zero TB Yogyakarta (ZTB) project. ZTB assigned a dedicated nurse to assist with active TB screening among PLHIV and recommended the immediate initiation of TPT as an innovation implemented. Data were obtained from the national HIV program reporting system, routinely reported by ART clinics from 2019 to 2022. We conducted a descriptive analysis, comparing the pre-intervention and intervention periods. During the intervention, there was a significant increase in PLHIV visits to healthcare facilities where TPT eligibility was assessed. At health centers, TB screening coverage for PLHIV decreased toward the end of the baseline period but recovered during the intervention. The number of PLHIV starting TPT also rose during the intervention. While the direct impact of ZTB is difficult to measure, the changes observed indicate progress in integrating TB/HIV services and enhancing TB prevention among PLHIV. Ongoing support, training, and supervision of healthcare facilities are crucial for improving TB screening and TPT provision.
自2014年以来，印度尼西亚国家结核病项目就建议对艾滋病毒感染者（PLHIV）进行结核病预防性治疗（TPT），但实施情况有限。本研究描述了2019年至2022年期间，在日惹零结核病（ZTB）项目支持的八家医疗机构中进行的结核病筛查和TPT启动情况。ZTB指派了一名专门护士协助对PLHIV进行活动性结核病筛查，并建议立即启动TPT作为一项实施的创新措施。数据来自国家艾滋病毒项目报告系统，由抗逆转录病毒治疗诊所于2019年至2022年定期报告。我们进行了描述性分析，比较了干预前和干预期间的情况。在干预期间，评估TPT资格的医疗机构中PLHIV的就诊人数显著增加。在健康中心，PLHIV结核病筛查覆盖率在基线期结束时下降，但在干预期间有所恢复。干预期间开始接受TPT的PLHIV人数也有所增加。虽然ZTB的直接影响难以衡量，但观察到的变化表明在整合结核病/艾滋病毒服务以及加强PLHIV结核病预防方面取得了进展。对医疗机构持续的支持、培训和监督对于改善结核病筛查和TPT提供至关重要。
