uptake of isoniazid preventive therapy and its associated factors among people living with hiv on antiretrovirals in kajiado county, kenya

Description

Human Immunodeficiency Virus /Tuberculosis co-infection is an important kind of infection due to its synergistic nature. HIV increases the chances of one acquiring TB by 16 to 27 times making HIV an important risk factor to TB infection, whereas individuals with healthy immune systems may not fall ill from TB infection, people living with HIV with a low CD4 count are at greater risk of TB infection. Kenya is one of the 14 countries globally that are in all the three lists of the 30 high-burden countries for TB, HIV/TB co-infection and MDR-TB.TB remains the most common cause of mortality among people living with HIV, recording for at least three AIDS-related deaths. IPT involves the administration of one or more of anti-tuberculosis drugs such as Isoniazid to individuals with latent infection with M.turberculosis in order to prevent progression to active TB disease. This study evaluated uptake of IPT and its associated factors among PLHIV on antiretroviral in Kajiado County, focusing on Socio-economic and demographic characteristics of PLHIV and determining level of patient knowledge on IPT. It was analytical cross-sectional study which targeted four hospitals purposely selected from Kajiado four sub-counties. Systematic sampling was used to sample 275 participants from the selected hospitals proportionately. Both quantitative and qualitative data were collected using structured questionnaires and Key informant interviews. Quantitative data were analyze using descriptive statistics Statistical Package for Social Sciences (SPSS) version 20. Bivariate analysis was carried out to compare PLHIV using IPT with those not using IPT regarding socio economic and demographic characteristics and other factors. The study showed that IPT uptake was at 72%, level of patient knowledge at 57%.Among the factors identified to be associated with IPT uptake. Patients‟ knowledge had the highest influence on IPT amongst PLHIV, followed by social-economic and demographic factors. There was a significant positive relationship (r=0.332, sig. =0.000) between patient knowledge and having ever used IPT at 0.01 level in a two tailed test. The correlation between demographic factors and having ever used IPT was significant (r=0.139, p=0.022) and positive at 0.05 level in a two tailed test. The study recommends that to increase IPT uptake, Kajiado County Government should target PLHIV with low economic abilities and special attention be paid to the aged, the women, unemployed people and respondents with no medical cover. It is recommended that more efforts be based on dissemination of information about IPT; in health centers, through health officers, and through trained health volunteers.