Belaynew Wasie Taye, Zemene Tigabu Kebede


Introduction: Isoniazid prevention therapy alone can reduce the risk of tuberculosis in people with HIV regardless of CD4 count or antiretroviral treatment. In Ethiopia, there is scarcity of evidence on implementation of isoniazid prevention therapy and factors associated with its uptake.

Objective: The study aimed to assess isoniazid preventive therapy implementation and factors associated with isoniazid completion among human immunodeficiency virus infected children in Felege-Hiwot and Gondar University Referral Hospitals in Northwest Ethiopia.

Methods: A facility-based cross-sectional study using a combination of face-to-face interviews of caregivers/parents and retrieval of client records was conducted in May 2014. Trained nurses with experience in human immunodeficiency virus infection and tuberculosis care conducted the document review and interviews. Data were entered onto Epi Info version 3.5.4 for windows, cleaned and exported to Statistical Package for Social Sciences version 20.0 for windows for analysis.

Results: A total of 454 HIV infected children (51.8% females and 48.2% males) were studied. Nearly a third, 168 (37%),of children were provided isoniazid prevention therapy and 67.9% completed the full course. Isoniazid completion was associated with distance from hospital (p<0.005), explanation of the reasons to take isoniazid pills (p<0.001), thinking isoniazid may be dangerous to child’s health (p<0.001), believing that the chance of getting sick from tuberculosis is high for the child (p<0.001), disclosure of human immunodeficiency virus infection status (p<0.04) and isoniazid preventive therapy disclosure status (p<0.001).

Conclusions: Uptake of isoniazid preventive therapy was low among human immunodeficiency virus infected children. In addition, isoniazid therapy completion was very low. The hospitals and Regional Health Bureau should avail isoniazid preventive therapy in the nearby health facilities and strengthen adequate counseling on the role of isoniazid preventive therapy for tuberculosis.

Key words: Tuberculosis; isoniazid preventive therapy; completion; children; Ethiopia.


Full Text:



World Health Organization (WHO). Global tuberculosis report 2013: World Health Organization; 2013.

World Health Organization (WHO). World health statistics 2010: World Health Organization; 2010.

Ramos JM, Reyes F, Tesfamariam A. Childhood and adult tuberculosis in a rural hospital in Southeast Ethiopia: a ten- year retrospective study. BMC public health. 2010;10:215. Epub 2010/04/29.

Munoz-Sellart M, Yassin MA, Tumato M, Merid Y, Cuevas LE. Treatment outcome in children with tuberculosis in southern Ethiopia. Scandinavian journal of infectious diseases. 2009;41(6-7):450-5. Epub 2009/12/17.

World Health Organization (WHO). TB/HIV facts 2011-2012. Geneva, Switzerland: WHO. 2012.

Zwang J, Garenne M, Kahn K, Collinson M, Tollman SM. Trends in mortality from pulmonary tuberculosis and HIV/AIDS co-infection in rural South Africa (Agincourt). Tran Royal Society Trop Med and Hyg. 2007;101(9):893-8. Epub 2007/06/29.

Batungwanayo J, Taelman H, Dhote R, Bogaerts J, Allen S, Van de Perre P. Pulmonary tuberculosis in Kigali, Rwanda. Impact of human immunodeficiency virus infection on clinical and radiographic presentation. The American review of respiratory disease. 1992;146(1):53-6. Epub 1992/07/01.

Ramirez-Cardich ME, Kawai V, Oberhelman RA, Bautista CT, Castillo ME, Gilman RH. Clinical correlates of tuberculosis co-infection in HIV-infected children hospitalized in Peru. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2006;10(4):278-81. Epub 2006/03/17.

World Health Organization (WHO). Global tuberculosis control: WHO report 2010: World Health Organization;2010.

World Health Organization (WHO). Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings. 2011.

Frigati LJ, Kranzer K, Cotton MF, Schaaf HS, Lombard CJ, Zar HJ. The impact of isoniazid preventive therapy and antiretroviral therapy on tuberculosis in children infected with HIV in a high tuberculosis incidence setting. Thorax. 2011;66(6):496-501. Epub 2011/04/05.

Bell JC, Rose DN, Sacks HS. Tuberculosis preventive therapy for HIV-infected people in sub-Saharan Africa is cost-effective. AIDS. 1999;13(12):1549-56. Epub 1999/08/28.

Cohen T, Lipsitch M, Walensky RP, Murray M. Beneficial and perverse effects of isoniazid preventive therapy for latent tuberculosis infection in HIV-tuberculosis coinfected populations. Proceedings of the National Academy of Sciences of the United States of America. 2006;103(18):7042-7. Epub 2006/04/25.

Harries AD, Zachariah R, Corbett EL, Lawn SD, Santos-Filho ET, Chimzizi R, et al. The HIV-associated tuberculosis epidemic-when will we act? Lancet. 2010;375(9729):1906-19. Epub 2010/05/22.

Hiransuthikul N, Hiransuthikul P, Nelson KE, Jirawisit M, Paewplot R, Kasak S. Physician adherence to isoniazid preventive therapy guidelines for HIV-infected patients in Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health. 2005;36(5):1208-15. Epub 2006/01/28.

Mindachew M, Deribew A, Tessema F, Biadgilign S. Predictors of adherence to isoniazid preventive therapy among HIV positive adults in Addis Ababa, Ethiopia. BMC public health. 2011;11:916. Epub 2011/12/14.

Seung KJ, Gelmanova IE, Peremitin GG, et al. The effect of initial drug resistance on treatment response and acquired drug resistance during standardized short-course chemotherapy for tuberculosis. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2004;39(9):1321-8. Epub 2004/10/21.

Marais BJ, Rabie H, Cotton MF. TB and HIV in Children - Advances in Prevention and Management. Paediatric Respiratory Reviews. 2011;12(1):39-45. Epub 2010/12/22.


  • There are currently no refbacks.

Comments on this article

View all comments

Kirkos Sub-City, Woreda 05
Roosevelt street, Infront of Africa Union main gate
Tel: +251 115 533742 Fax: +251 115 151005
P.O.Box 2179 Email:
Copyright © Ethiopian Medical Association 2018 All rights Reserved

Powered by OJS & Designed and Hosted by MAKE Enterprise