Ifeyinwa Chizoba Akamike Department of Community Medicine, Alex Ekwueme Federal University Teaching, Hospital, Abakaliki, Ebonyi State, Nigeria Ijeoma Nkem Okedo- Alex African Institute for Health Policy and Health Systems, Ebonyi State University, Nigeria Chigozie Jesse Uneke African Institute for Health Policy and Health Systems, Ebonyi State University, Nigeria Ugochukwu Chinyem Madubueze Alex Ekwueme Federal University, Ndufu Alike Ikwo, Ebonyi State, Nigeria Urudinachi Nnenne Agbo African Institute for Health Policy and Health Systems, Ebonyi State University, Nigeria Ifeyinwa Maureen Okeke African Institute for Health Policy and Health Systems, Ebonyi State University, Nigeria Lawrence Ulu Ogbonnaya Alex Ekwueme Federal University, Ndufu Alike Ikwo, Ebonyi State, Nigeria

Keywords: Tuberculosis prevention; Health provider; Implementation; Guideline; Nigeria

Abstract

Background

Isoniazid preventive therapy is recommended as part of a comprehensive HIV and AIDS care strategy. IPT is used as prophylaxis to reduce the incidence of TB in HIV-infected persons. However, its implementation has been very slow and has been influenced by several factors. This study assessed health workers’ knowledge and adherence to Isoniazid Preventive Therapy guidelines.

Methods

This was a cross-sectional study in six health facilities providing HIV care in Ebonyi State using a semi-structured, self-administered questionnaire. Data were collected from 85 health workers working in the HIV clinics. Data were also extracted from 200 patient treatment cards. Data analysis was carried out using SPSS version 20 software. Chi-square statistics and logistic regression were carried out to determine the association between socio-demographic characteristics and knowledge as well as self-reported practice of the guideline.

Result

Slightly over half of the respondents (58.8%) had good knowledge of the guideline, and the majority (75.3%) self-reported that they practiced the guideline. Only 17% of the treatment cards had isoniazid prescribed and only 11% of these had patient adherence assessed. The most common challenges to implementation of the guideline cited by health workers were unavailability of isoniazid, poor awareness, patient non-adherence, poor resources, high pill burden, and lack of training. Being a doctor and more than 3 years duration of work in the clinic were predictors of good knowledge. There was no predictor of practice.

Conclusion

There was good knowledge and practice of the guideline from health worker self-reports, however, review of treatment card showed prescription was low. Further studies to explore and understand why there is such low prescription of INH/IPT to HIV patients despite good knowledge of healthcare professionals are recommended.

Section

Original Research

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