{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:58:12Z","timestamp":1781614692674,"version":"3.54.5"},"reference-count":23,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,26]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine trends and factors associated with isoniazid preventive therapy (IPT) initiation among people living with HIV (PLHIV) aged \u226515 years who initiated antiretroviral therapy (ART) in mainland Tanzania between 2015 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective observational study using routinely collected data. Multilevel logistic regression analysis was used to identify factors associated with IPT initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>HIV care and treatment clinics across mainland Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study included PLHIV aged \u226515 years who initiated ART between 2015 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was IPT initiation among eligible PLHIV. Secondary outcomes included trends in IPT initiation from 2015 to 2020 and factors associated with IPT initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 124 846 PLHIV (mean age 35.8\u00b111.40 years), cumulative IPT initiation was 59.8% (10.50% at first visit; 21.70% within 3 months). Initiation trend increased from 52.70% in 2015 to 68.30% in 2020 (2.05, p&lt;0.02). Factors positively associated with IPT initiation included female sex (adjusted OR (aOR) 1.10, 95% CI 1.10 to 1.20), (aOR, CI) working functional status compare to bedridden (aOR 1.90, 95% CI 1.50 to 2.50), care at a health centre versus dispensary (aOR 1.60, 95% CI 1.30 to 2.00), residence in the Lake zone versus Central zone (aOR 2.50, 95% CI 1.60 to 3.80), ART initiation in 2020 compare to 2015 (aOR 2.00, 95% CI 1.90 to 2.20), WHO HIV stage II versus stage IV (aOR 2.10, 95% CI 1.90 to 2.30) and age 45\u201354 years compare to 15\u201324 years (aOR 1.90, 95% CI 1.80 to 2.10).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although IPT initiation among PLHIV in mainland Tanzania improved between 2015 and 2020, coverage remained suboptimal. Strengthened efforts are needed to ensure all PLHIV initiating ART are appropriately screened for tuberculosis (TB), initiated on IPT if eligible and promptly treated if diagnosed with active TB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107250","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:25:18Z","timestamp":1781612718000},"page":"e107250","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and determinants of isoniazid preventive therapy initiation in antiretroviral therapy-treated HIV-positive adults in Tanzania Mainland 2015\u20132020: a retrospective observational study using medical records"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0206-5572","authenticated-orcid":false,"given":"Elvis Bazil","family":"Meela","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"G","given":"Gilbert","family":"Waria","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0442-3203","authenticated-orcid":false,"given":"Laura J","family":"Shirima","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Lucas","family":"Mlay","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ngowi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6952-2399","authenticated-orcid":false,"given":"Abdallah Abtwalibe","family":"Maghembe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2890-631X","authenticated-orcid":false,"given":"Joseph","family":"Meela","sequence":"additional","affiliation":[{"name":"School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Somi","family":"Pallangyo","sequence":"additional","affiliation":[{"name":"Mawenzi Regional Referral Hospital, Ministry of Health Tanzania (MOH), Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Balati","sequence":"additional","affiliation":[{"name":"Department of Health, Christian Social Service Commissions, Dar es salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Maokola","sequence":"additional","affiliation":[{"name":"National AIDS Control Program (NACP), Ministry of Health Tanzania (MOH), Dodoma, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrasia","family":"Hugho","sequence":"additional","affiliation":[{"name":"Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6242-9863","authenticated-orcid":false,"given":"James Samwel","family":"Ngocho","sequence":"additional","affiliation":[{"name":"Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"2026061605250826000_16.6.e107250.1","unstructured":"WHO . 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