Implementing 3HP vs. IPT as TB preventive treatment in Pakistan
METHODS: All household contacts were clinically evaluated to rule out TB disease. 6H was used for TB preventive treatment (TPT) from October 2016 to April 2017; from May to September 2017, 3HP was used for contacts aged ≥2 years. We compared clinical evaluation, TPT uptake and completion rates between contacts aged ≥2 years in the 6H period and in the 3HP period.
RESULTS: We identified 3,442 contacts for the 6H regimen. After clinical evaluation, 744/1,036 (72%) started treatment, while 46% completed treatment. In contrast, 3,722 contacts were identified for 3HP. After clinical evaluation, 990/1,366 (72%) started treatment, while 67% completed treatment. Uptake of TPT did not differ significantly between the 6H and 3HP groups (OR 1.03, 95%CI 0.86–1.24). However, people who initiated 3HP had 2.3 times greater odds (95% CI 1.9–2.8) of completing treatment than those who initiated 6H after adjusting for age and sex.
CONCLUSION: In programmatic settings in a high-burden country, household contacts of all ages were more likely to complete TPT with shorter weekly regimens, although treatment uptake rate for the two regimens was similar.
Keywords: Pakistan; TB preventive therapy; TPT; completion; household contacts; latent infection; shorter regimen; uptake
Document Type: Research Article
Affiliations: 1: Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK 2: TB Control Programme, The Indus Hospital and Health Network, Karachi, Pakistan 3: Programmes Unit, Aga Khan Health Services, Karachi, Pakistan 4: Monitoring & Evaluation, Public Health England, London, UK 5: TB Department, Interactive Research and Development (IRD) Global, Singapore 6: TB Department, Interactive Research and Development (IRD) Global, Singapore, TB Department, Harvard Medical School, Boston, MA, Infectious Diseases, Harvard Medical School Center for Global Health Delivery, Boston, MA 7: TB Department, Harvard Medical School, Boston, MA, Infectious Diseases, Harvard Medical School Center for Global Health Delivery, Boston, MA 8: TB Department, Harvard Medical School, Boston, MA, Infectious Diseases, Harvard Medical School Center for Global Health Delivery, Boston, MA, TB Department, Partners In Health, Boston, MA, Infectious Diseases, Brigham and Women´s Hospital, Boston, MA 9: TB Department, Interactive Research and Development (IRD) Global, Singapore, Internal Medicine, Yale School of Medicine, New Haven, CT, Yale Institute for Global Health, New Haven, CT, USA
Publication date: August 1, 2022
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