Implementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countries

M. Katherine CharlesMary Lou LindegrenC. William WesterMeridith BlevinsTimothy R. SterlingNguyen Thi DungJean Claude DusingizeDivine Avit-EdiNicolas DurierBarbara CastelnuovoGertrude NakigoziClaudia P. CortesMarie BallifLukas FennerSamuel AjayiKathryn AnastosJules BashiWilliam BishaiAndrew BoullePaula BraitsteinGabriela CarriquiryJane E. CarterPeter CegielskiCleophas ChimbeteteMary Ann DaviesLameck DieroStephany DudaMatthias EggerTanoh François EbouaAdrian GasserElvin GengJoachim Charles GnokoriLaura HardwickeChristopher HoffmannRobin HuebnerNzali KancheyaS. KiertiburanakulPeter KimDiero LameckValériane LeroyCharlotte LewdenAnna MandalakasMhairi MaskewRosemary McKaigLynne MofensonMireille Mpoudi-EtameBenson OkwaraSam PhiriWasana PrasitsuebsaiApril PetitHans ProzeskyStewart E. ReidLorna RennerGary ReubensonAnnette SohnQuynh VoDana WalkerFiras WehbeChristian WejseCarolyn WilliamsRobin WoodKara Wools-KaloustianZhang YaoEvy YunihastutiF. J. ZhangH. X. ZhaoN. HanT. P. MeratiD. N. WirawanF. YulianaR. DitangcoE. UyR. BantiqueP. PhanuphakK. RuxrungthamA. AvihingsanonM. KhongphattanayothinS. SungkanuparphN. SanmeemaR. ChaiwarithT. SirisanthanaW. KotarathititumT. T. PhamD. D. CuongH. L. HaV. K. NguyenV. H. BuiT. D. NguyenA. H. SohnB. PetersenD. A. CooperVanderbilt University School of MedicineNational Hospital of Tropical DiseasesWomen's Equity in Access to Care and TreatmentCentre MTCT-plusamfAR - The Foundation for AIDS ResearchInfectious Diseases InstituteRakai Health Sciences ProgramFacultad de Medicina de la Universidad de ChileInstitut fur Sozial- und PraventivmedizinSwiss Tropical and Public Health Institute (Swiss TPH)Universitat BaselBeijing Ditan HospitalUniversitas UdayanaGokilaThe HIV Netherlands Australia Thailand Research CollaborationMahidol UniversityResearch Institute for Health SciencesBach Mai HospitalUniversity of New South Wales (UNSW) AustraliaPenang HospitalKhon Kaen UniversityAlbert Einstein College of Medicine of Yeshiva UniversityNewlands ClinicAurum Institute for Health ResearchLighthouse TrustTygerberg HospitalUniversiteit StellenboschDesmond Tutu HIV CentreUniversity of Cape TownCNHU Hubert MagaCentre Hospitalier Universitaire de YopougonKorle Bu HospitalBandim Health ProjectUATHnull2018-12-112019-03-142018-12-112019-03-142016-04-01PLoS ONE. Vol.11, No.4 (2016)193262032-s2.0-84963770998https://repository.li.mahidol.ac.th/handle/20.500.14594/41048© 2016 Charles et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Setting: World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), and infection control ("Three I's") for TB prevention and control among persons living with HIV. Objective: To assess the implementation of the "Three I's" of TB-control at HIV treatment sites in lower income countries. Design: Survey conducted between March-July, 2012 at 47 sites in 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central and South America, 5 (10%) Central Africa, 8 (17%) East Africa, 14 (30%) Southern Africa, and 7 (15%) West Africa. Results: ICF using symptom-based screening was performed at 38% of sites; 45% of sites used symptom-screening plus additional diagnostics. IPT at enrollment or ART initiation was implemented in only 17% of sites, with 9% of sites providing IPT to tuberculin-skin-test positive patients. Infection control measures varied: 62% of sites separated smear-positive patients, and healthcare workers used masks at 57% of sites. Only 12 (26%) sites integrated HIV-TB services. Integration was not associated with implementation of TB prevention measures except for IPT provision at enrollment (42% integrated vs. 9% nonintegrated; p = 0.03). Conclusions: Implementation of TB screening, IPT provision, and infection control measures was low and variable across regional HIV treatment sites, regardless of integration status.Mahidol UniversityAgricultural and Biological SciencesBiochemistry, Genetics and Molecular BiologyImplementation of tuberculosis intensive case finding, isoniazid preventive therapy, and infection control ("Three I's") and HIV-tuberculosis service integration in lower income countriesArticleSCOPUS10.1371/journal.pone.0153243