Tuberculosis preventative therapy uptake in people living with HIV at a tertiary care hospital in Cape Town

Abstract

Background: South Africa ranks among the 30 countries with the highest burden of tuberculosis (TB) – contributing about 3.3% of global TB cases. The nation faces a dual epidemic of TB and human immunodeficiency virus (HIV), with a staggering 61% of TB cases in South Africa being coinfected with HIV as of 2021. Effective TB prevention strategies are critical public health interventions that could reduce TB incidence, morbidity, and mortality. Notably, tuberculosis preventative therapy (TPT) has demonstrated a 37% reduction in risk of mortality for people living with HIV (PLHIV). However, TPT uptake has been hindered globally due to various programmatic challenges and the adverse impacts of the COVID-19 pandemic, leading to a concerning 21% decline in TPT provision between 2019 and 2022. This decline underscores the urgent need for revitalization of essential TB services (including prevention, detection, and treatment) to combat this persistent public health crisis effectively. Aim: This study aimed to investigate the uptake of TPT among PLHIV attending the infectious disease clinic at a tertiary care hospital in the Western Cape (WC) province of South Africa. Methods: A quantitative observational, cross-sectional descriptive study was conducted to assess the uptake of TPT among PLHIV attending the infectious disease clinic at a tertiary care hospital in the WC province. This retrospective analysis reviewed patient records over the past year, using a systematic sampling method to select a cohort of 228 HIV-positive individuals (including children and adults), based on predefined inclusion and exclusion criteria.