ORIGINAL ARTICLES Barriers and Facilitators of Isoniazid Preventive Therapy Implementation among People Living with HIV in Nigeria: A Scoping Review of the Literature

West Afr J Med . 2023 Mar 31;40(3):336-344.

Abstract

Abstract  in English, French

Background: Implementation of Isoniazid Preventive Therapy (IPT) among People Living with HIV (PLHIV) continues to be a significant challenge, and there is a shortage of effective interventions. This scoping review aimed to determine barriers and facilitators of IPT implementation including its uptake and completion among PLHIV in Nigeria.

Methods: PubMed, Medline Ovid, Scopus, Google scholar, web of science and Cochrane Library were searched for articles published between January 2019 to June 2022 that addressed barriers and facilitators of IPT uptake and completion in Nigeria. The study used the PRISMA checklist to ensure the quality of the study.

Results: The initial search revealed 780 studies, of which 15 studies were finally included in the scoping review. The authors inductively organized IPT barriers among PLHIV into patients-, health system-,programmatic- and provider-related barriers. Facilitators of IPT were sub-categorized into programmatic (Monitoring and Evaluation or logistic), patient-related and provider-related (capacity building) and health systems sub-categories. Most studies highlighted more barriers than facilitators, and across all studies, IPT uptake was 3% - 61.2% while IPT completion was 40 - 87.9% but these figures are higher in quality improvement studies.

Conclusion: Identified barriers include health system, and programmatic-across, and in all the studies, IPT uptake was 3%-61.2%. Cost-effective and locally developed interventions addressing context-specific barriers should be developed to address patient, provider, programmatic, and health systems-specific findings in our study with a clear understanding that there may be other barriers limiting uptake and completion of IPT at the level of community and caregivers.

Keywords: Barriers; Completion; Facilitators; Isoniazid preventive therapy; People living with HIV; Uptake.

V A Adepoju ^1 2, A Adelekan ³, O E Adepoju ², O I Onyezue ⁴, W Imoyera ¹, A Nkeiruka ⁵, A B Olofinbiyi ^2 6