South Africa: Community Care Model Improves Uptake of TB Preventive Therapy, KZN Study Finds

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South Africa: Community Care Model Improves Uptake of TB Preventive Therapy, KZN Study Finds
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Community Care Model Improves Uptake of TB Preventive... SpotlightNSP: SouthAfrica

Among others, TB preventive therapy is recommended for people living with HIV in South Africa, a group that is at an increased risk of developing TB. The risk is higher when someone's CD4 count is low - an indication that the immune system is compromised. The most common form of TB prevention therapy used in South Africa is an isoniazid pill taken for six or more months . A shorter three-month regimen consisting of the drugs rifapentine and isoniazid is being piloted in some districts.

"For participants who did not initiate IPT at the month one visit, catch-up IPT could start at any subsequent visit," Shapiro says. She explains that IPT initiation and continuation in the community and hybrid arms were measured with medication dispensing records and self-reported adherence given at the follow-up visits.

"We found that initiation and continuation of TB preventive therapy were significantly higher with community-delivered HIV care than clinic-based treatment," says Shapiro."In the DOART study in South Africa, multi-month dispensing of IPT was safe and acceptable and use of point-of-care urine Isoniazid testing can enhance adherence monitoring," she says.

"Overburdened health systems also do not allow time for clinicians to dispense ART and counsel clients on TPT, therefore, TPT is seldom offered nor demanded by clients as they know very little about it," she says."We live in an age where clients have different lifestyles and clinical services need to evolve to suit the client's needs.

She explains they tried to keep study conditions as true to the clinic setting as possible, so the IPT regimen given for six months was used because that's what the public healthcare clinics they worked with in KZN were providing to patients.The study was close to real-world conditions in other ways as well.

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