Factor Associated with Treatment Noncompletion during Implementation of Isoniazid-Preventive Therapy in Ten Pilot Sites of Lome, Togo

BACKGROUND: Tuberculosis (TB) represents the leading cause of death among people living with HIV (PLHIV). Several studies have proven the effectiveness of isoniazid-preventive treatment (IPT) in reducing the incidence and mortality of TB. The study aims to identify the factors associated with noncompletion of the treatment during the pilot phase of IPT implementation. METHODS: This was a retrospective cohort study using data routinely collected in ten PLHIV care centers in Lomé, Togo, conducted between June 1, 2019, and March 31, 2020. All confirmed PLHIV newly enrolled in care who gave consent were included. IPT tolerance and signs of TB were checked at each appointment. To identify the factors associated with noncompletion of treatment, a logistic regression model was developed. RESULTS: Sixty-five percent of the 301 patients were female. The mean age was 39.8 ± 13.2 years. Respectively, 43.8% and 41.9% of the patients were at clinical stages 1 and 2. The mean completion rate was 42.9% with extremes depending on the center ranging from 9.5% to 90.0%. The main causes of noncompletion were isoniazid stockouts (45.9%), lost to follow-up (37.8%), and noncompliance (12.8%). Multivariate analysis identified stockouts, public type of center, and poor general condition at the inclusion as risk factors for noncompletion. CONCLUSIONS: Good results obtained by some centers prove that the implementation of the intervention is indeed possible, as long as good management of drug stocks and better follow-up of patients are ensured.