Tuberculosis screening and isoniazid preventive therapy implementation: a Brazilian experience

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Trials

Background:

• Isoniazid preventive therapy (IPT) is recommended by the WHO to reduce tuberculosis (TB) burden in people living with HIV.
• Poor uptake of IPT in high TB burden countries is a significant challenge.
• Concerns about ruling out active TB and the need for effective screening are major barriers to IPT implementation.

Purpose of the Study:

• To evaluate an intervention aimed at improving the uptake and effectiveness of IPT in HIV-infected individuals.
• To assess the impact of staff training, tuberculin skin testing, and symptom-based screening on TB and mortality rates.

Main Methods:

• A randomized clinical trial was conducted to assess the intervention's effect.
• The intervention included training clinic staff on TB screening, utilizing tuberculin skin tests, and administering IPT for latent TB infection.
• The study monitored rates of TB and death in HIV-infected participants.

Main Results:

• The intervention demonstrated a positive effect on the rates of TB and death among HIV-infected individuals.
• Improved screening and IPT administration were key components of the successful intervention.
• The study addressed barriers to IPT implementation by providing a structured approach to screening and treatment.

Conclusions:

• The evaluated intervention is effective in increasing the uptake and impact of Isoniazid preventive therapy in HIV-infected populations.
• Training healthcare workers and implementing standardized screening protocols are crucial for successful IPT programs.
• This strategy holds promise for reducing the TB burden in high-risk groups globally.