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Published on: April 9, 2012
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Taking tuberculosis preventive therapy implementation to national scale: the Nigerian PEPFAR Program experience.
B Odume1, S C Meribe2, T Odusote3
1Division of Global HIV/AIDS and TB, United States (US) Centers for Disease Control and Prevention, Abuja, Nigeria.
Public Health Action
|May 6, 2020
Summary
Integrating isoniazid (INH) logistics into the HIV program significantly increased tuberculosis preventive therapy (TPT) uptake in Nigeria. This improvement addresses key bottlenecks, enhancing care for people living with HIV.
Area of Science:
- Public Health
- Infectious Disease Management
- Health Systems Strengthening
Background:
- Tuberculosis (TB) preventive therapy (TPT), including isoniazid preventive therapy (IPT), has been part of Nigeria's human immunodeficiency virus (HIV) program since 2014.
- Drug procurement and logistics for TPT were managed by the National Tuberculosis and Leprosy Control Programme, presenting implementation challenges.
- The US President's Emergency Plan for AIDS Relief-Nigeria (PEPFAR Nigeria) identified critical bottlenecks in TPT implementation in 2016.
Purpose of the Study:
- To review and address key bottlenecks in the implementation of tuberculosis preventive therapy (TPT) within Nigeria's HIV program.
- To improve the logistics and uptake of isoniazid preventive therapy (IPT) for individuals living with HIV.
Main Methods:
- Integrated the logistics of isoniazid (INH) delivery with the existing antiretroviral (ARV) logistics management and information system (LMIS).
- Revised facility-level drug order and requisition forms to include INH, alongside ARVs.
- Provided training on INH quantification and requisition, and supported direct last-mile delivery of INH to all implementing sites.
Main Results:
- Observed a consistent increase in TPT uptake: 6% in FY2015, 7% in FY2016, and 12% in FY2017.
- Logistical integration of INH into the LMIS in 2016 resulted in a statistically significant 69% increase in TPT uptake by the end of FY2017.
Conclusions:
- Addressing logistical challenges is crucial for TB and HIV programs to manage the growing burden of TB in people living with HIV.
- Recommended that the HIV program lead the provider-to-client stage of TPT implementation.
- Emphasized the need for improved cross-communication between TB and HIV programs for effective TPT delivery.
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