Characterising isoniazid preventive therapy uptake among people living with HIV in Tanzania, a resource-constrained setting with a high tuberculosis burden: A systematic review and meta-analysis

Abstract

• Isoniazid preventive therapy uptake among people with HIV in Tanzania remains low • Barriers to IPT include: supply chain, patients oriented and program monitoring • Implementation strategies to increase IPT uptake in Tanzania should be strengthened. Tuberculosis (TB) disease remains highly prevalent among people living with HIV (PLHIV) in Tanzania, despite the implementation of the isoniazid preventive therapy (IPT) programme in 2009. This study aimed to characterise the uptake of IPT in Tanzania. We searched PubMed, Web of Science, Google Scholar and Embase for potentially eligible studies published in English from inception to February 2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The research articles included participants aged 10 years and older living with HIV who had started IPT as per WHO recommendations. We used STATA 17.0 software for data analysis. Random-effects models were used to pool the effect estimates and account for between study heterogeneity. The overall prevalence of IPT uptake was 23.61% (95% CI: 14.00 – 34.83, p<0.01). Cases of TB among those on IPT was 2.72%. The prevalence of IPT completion was 82.40% (95% CI: 50.54 – 99.41, p<0.01), with a greater prevalence among females 74.42% (95% CI: 71.48 – 77.27, p = 0.01) and those with CD4 <350 52.74% (95% CI: 19.55 – 84.61, p<0.01). The overall uptake of IPT is still low among PLHIV, but the completion among those taking the therapy is high. Measures are required to increase IPT uptake in this population group. PROSPERO ID #: CRD42024522469