Uptake of isoniazid preventive therapy and its associated factors among HIV positive patients in an urban health centre, Kenya

Abstract

Background: Isoniazid Preventive Therapy (IPT) is an effective intervention for prevention of tuberculosis (TB) among HIV positive patients, and its use is recommended by the World Health Organization (WHO). Unfortunately the uptake of IPT in Kenya remains low (33%-40%) with limited knowledge on the factors that affect its uptake.

Objective: To determine the uptake of IPT and its associated factors among HIV-positive patients enrolled in a urban health centre.

Design: Hospital based cross-sectional study

Setting: Riruta Health Centre, Nairobi, Kenya

Subjects: HIV-positive patients ≥18 years who have been on care and treatment services in the health centre for at least six months preceding the study.

Results: Four hundred and thirty six participants were enrolled with a mean age of 41 years (standard deviation± 9years). Females were 276 (63%), anti-retroviral therapy uptake of 427 (98%) and overall IPT uptake rate of 336 (77%). On multivariate analysis, fear of acquiring TB (adjusted odds ratio (AOR) 4.6, 95% confidence interval, CI 2.6-8.1), having received IPT-associated health education (AOR 5.0, 95% CI 3.0-8.4) and having a good relationship with the healthcare worker (HCW) (AOR 2.0, 95% CI 1.2-3.4) were independently associated with initiation of IPT.

Conclusion: The uptake rate was above the current national coverage but fell below the national set target of 90%. Fear of acquiring TB, receipt of IPT-associated health education and favourable relationship with the HCWs promoted the initiation of IPT