BACKGROUND: Isoniazid (H) and rifapentine (P) given once weekly for three months (3HP) was included in the list of the recommended regimen by World Health Organization (W.H.O) in March 2018, for the prevention of tuberculosis (TB) in a high-risk group. Kenya adopted WHO recommendation in 2020. The 3HP regimen is associated with less toxicity, better adherence, and improved treatment completion rates compared. The primary goal of the evaluation was to assess the routine programmatic implementation of 3HP (uptake and completion rates) for the PLHIV > 15 years.
DESCRIPTION: This was an observational evaluation across the two sentinel sites using routine patient-level information for a cohort of patients retrospectively from patient files and registers at Thika Level 5 and Ruiru-sub county hospital. A total of 503 patient files from 546 patients enrolled into care were evaluated, and anonymized patient level data was abstracted from the facility’s electronic medical records registers and keyed in a secure, encrypted data collection tool only accessible by TB program staff in the country for analysis.
LESSONS LEARNED: Of the 546 PLHIV enrolled into care between January to December 2021 in the two sentinel sites, (92%) 503 PLHIV were started on 3HP with a median age of 39 years. Females comprised almost 60% (N=301) of patients initiated on 3HP. Of those initiated on 3HP, only 164 (32,6%) were ART treatment naïve with less than 90 days on ART and the rest were non-naive. Of the 503 PLHIV who initiated 3HP, 94,8% (N=477) completed their 3HP treatment course. Ten individuals (2%) discontinued treatment, five were lost to follow-up, one died, 7 (1.4%) did not have their treatment outcome determined, and two developed TB and initiated on first line treatment. Of then ten who discontinued 3HP only two who stopped due to toxicity.
CONCLUSIONS: The conclusion from the evaluation shows that from the high-risk population evaluated (PLHIV) from the two sentinel sites, there is enough evidence that 3HP may provide suitable and ideal treatment for latent TB infection with few side effects, high completion rate, low death rate, and low TB disease during and after Rifapentine and isoniazid treatment.