Tuberculosis Preventive Therapy for HCWs.pptx

Tuberculosis preventive therapy

1. Preventive TB treatment completion Regimen Total duration (months) Expected number of doses (100%) Extended time for treatment Completion (treatment duration +33% additional time) Remark on completion criteria for TPT Regimens in Ethiopia 3HP 3 12 120 days (4 months) Completion of the 12 doses within 4 months period 3HR 3 90 120 days(4 months) Completion of the 84 doses within 4 months period 6H 6 180 240 days (8 months) Completion of the 168 doses within 8 months period

2. Management of interruptions in TB preventive treatment TPT regimen Duration of treatment interruption Recommended Actions 3HR, 6H Less than 2 weeks Resume preventive treatment immediately upon return and add the number of days of missed doses to the total treatment duration Do not change the scheduled date of the next follow-up visit but the last follow-up visit will be postponed by the number of extra-days to compensate for missed doses (e.g. If a child on 3HR missed 3 days of treatment, continue preventive treatment for a total duration of 3 months + 3 days from the date of start). More than 2 weeks If treatment interruption occurred after more than 80% of doses expected in the regimen were taken, no action is required. Continue and complete the remaining treatment as per original plan. If less than 80% of doses expected in the regimen were taken, and the treatment course can still be completed within the expected time for completion, i.e. treatment duration + 33% additional time, no action is required. Continue and complete the remaining treatment as per original plan. If less than 80% of doses expected in the regimen were taken, and the treatment course cannot be completed within the expected time for completion, consider restarting the full TPT course.

3. Management of interruptions in TB preventive treatment TPT regimen Duration of treatment interruption Recommended Actions 3HP Weekly schedule of one dose Missed If the missed dose is remembered within the next 2 days, the person can take the dose immediately. Continue the schedule as originally planned (i.e. continue to take remaining doses following the same schedule). If the missed dose is remembered more than 2 days later, the person can take the missed dose immediately and change the schedule for weekly intake to the day the missed dose was taken until treatment completion. This will avoid two weekly doses being taken less than 4 days apart. More than 1 weekly doses of 3HP missed If 1–3 weekly doses are missed, treatment is continued until all 12 doses are taken, thus prolonging the treatment duration to a maximum of 16 weeks If, however, 4 or more weekly doses are missed, consider restarting the full TPT course. If adherence to a weekly routine is not possible, consider discontinuing 3HP and offering an alternative (daily) regimen.

4. Program management, monitoring and evaluation of TPT The key indicators for monitoring of TPT include: Initiation of TPT among eligible groups (disaggregated by HIV status, contact status, sex, age and regimen type) Completion of TPT among eligible groups (disaggregated by HIV status, contact status, sex, age and regimen type)

5. Program management, monitoring and evaluation of TPT In addition to monitoring treatment initiation and completion, a number of unfavorable outcomes are proposed that could be used to trigger a review of case management and, in some instances, changes to treatment (see list below). Failed – development of TB disease any time while on TPT Died – death for any reason while on TPT Lost to follow-up – TPT interrupted by person for eight consecutive weeks or more for 6H, four consecutive weeks or more for 3HP and 3HR. TPT discontinuation due to toxicity – by clinician due to adverse events or drug–drug interactions, with or without restart or switching of regimen Not evaluated – such as records lost, transfer to another health facility with record of TPT Completion

6. FSWs Data HIV_Female comercial Sex workers : Received result HIV_Female comercial Sex workers :Positive Organisation unit / Period Hamle 2015 Nehase 2015 Meskerem 2016 Tikemet 2016 Hidar 2016 Tahesas 2016 Tir 2016 Yekatit 2016 Megabit 2016 Hamle 2015 Nehase 2015 Meskerem 2016 Tikemet 2016 Hidar 2016 Tahesas 2016 Tir 2016 Yekatit 2016 Megabit 2016 Awi ZHD 260 389 402 281 177 204 152 166 495 11 10 9 12 10 9 6 13 17 Ag PH Ankasha 9 Ayehu 103 49 17 11 15 4 29 2 1 1 1 1 Banja 4 15 CPH Chagni 95 146 139 88 46 56 68 55 92 4 2 4 5 4 3 2 9 6 DPH 7 3 3 2 3 1 3 Dangla Town 58 65 36 58 17 14 2 3 136 2 1 2 1 7 Dangla Z 1 1 Fagitalekoma 13 36 23 8 8 6 Guagusa 2 41 2 Guangua 81 29 2 IGH 30 1 Injibara Town 35 29 68 92 54 106 57 104 147 3 5 5 4 4 6 2 3 1 Jawi 6 6 29 20 4 3 32 1 JPH 1 1 1 Zigem

7. FSWs . Data HIV_Female commercial Sex workers : Received result HIV_Female commercial Sex workers :Positive Organisation unit / Period Hamle 2015 Nehase 2015 Meskerem 2016 Tikemet 2016 Hidar 2016 Tahesas 2016 Tir 2016 Yekatit 2016 Megabit 2016 Hamle 2015 Nehase 2015 Meskerem 2016 Tikemet 2016 Hidar 2016 Tahesas 2016 Tir 2016 Yekatit 2016 Megabit 2016 Awi ZHD 260 389 402 281 177 204 152 166 495 11 10 9 12 10 9 6 13 17 Ayehu Guagusa 103 49 17 11 15 4 29 2 1 1 1 1 Dangila PHCU 58 65 36 58 17 14 2 3 136 2 1 2 1 7 Chagni PHCU 43 74 96 41 25 33 31 20 55 2 2 1 5 2 Chagni DIC 52 72 43 47 21 23 37 35 37 4 2 2 5 4 1 1 4 4 Tilili PHCU 41 2 Injibara PHCU 15 7 56 48 31 70 31 89 119 1 4 1 2 1 1 3 Enjibara DIC 20 22 12 44 23 36 26 15 28 2 5 1 3 2 5 1 1

8. FSWs . Organisation unit Female comercial Sex workers Tested Female comercial Sex workers :Positive Yield Agew Gimjabet PH - Ankasha Guagusa 9 0.0% Ayehu Guagusa 228 7 3.1% Banja 19 0.0% Chagni PH - Chagni Town 785 42 5.4% Dangla Primary Hospital 22 0.0% Dangla Town 389 13 3.3% Dangla Zuria 1 1 100.0% Fagitalekoma 94 0.0% Guagusa Shikudad 43 2 4.7% Guangua 112 0.0% Injibara GH 30 1 3.3% Injibara Town 692 33 4.8% Jawi 100 1 1.0% Jawi Primary Hospital 2 1 50.0% Zigem - Awi ZHD 2526 101 4.0%