Survey of isoniazid preventive therapy in South Africa, 2011

SETTING: Public health facilities in South Africa. OBJECTIVE: To assess the implementation of isoniazid preventive treatment (IPT) in South Africa in 2011. DESIGN: Cross-sectional study of 50 randomly selected facilities in South Africa. Trained interviewers administered a standardised questionnaire at each facility on aspects of IPT policy, implementation and recording and reporting. We calculated and compared descriptive statistics by province and facility type. RESULTS: Of the 49 participating sites, 35 provided IPT (71%). IPT was not available in any Western Cape facility (0%), and it was available at a few Mpumalanga (40%) and Limpopo (20%) sites. In February 2011, 46% of eligible human immunodeficiency virus (HIV) infected patients at IPT-providing sites had been initiated on IPT. Implementation by facility type was 27% among community health centres. Of all facilities with integrated tuberculosis (TB) and HIV committees (TB-HIV), 85% offered IPT compared to 59% of those without TB-HIV committees (P = 0.12). Availability of the 2010 South African National IPT guidelines was statistically significantly associated with sites providing IPT (84% vs. 29%, P = 0.006). CONCLUSION: IPT implementation in South Africa began in February 2011. The availability of IPT guidelines was strongly associated with IPT uptake. More operational studies are needed to improve IPT implementation among HIV-infected patients in South Africa.