Oint United Nations Programme on HIV/AIDS (UNAIDS) to enable the effective prevention, diagnosis and treatment of TB in PLWHAPLOS ONE | www.plosone.orgAdherence to Isoniazid Preventive Therapy[6,7,8]. The recommended regimen for TB preventive therapy in adolescents and adults is isoniazid (isonocotic acid hydrazide ?INH), 300 mg daily for at least 6 months [8,9]. A Cochrane review assessing the effectiveness of TB preventive therapy in reducing the risk of active TB and death in persons infected with HIV, `confirms that chemoprophylaxis with anti-tuberculosis drugs reduces the risk of clinical tuberculosis in HIV infected populations’ [10]. The review also cautions about the dangers of `poor adherence and drug resistant TB disease potentially associated with the use of long courses of isoniazid monotherapy’ [10]. Various health system related constraints have impeded the uptake of IPT. Only 12 of PLWHA who were newly enrolled in HIV care programmes were started on IPT, worldwide, in 2010 [1,9]. Adherence to treatment is a critical factor that needs to be considered in scaling up services in developing countries [9,10,11]. This paper seeks to systematically review the evidence on adherence to IPT with a view to assessing and interpreting deterrent and enabling factors associated with observed trends in non-adherence.Science and Google Scholar, identified two additional recent studies. The search strategy for MEDLINE on OvidSP is provided as supporting information: Ovid MEDLINE Search strategy, Table S1. Our search was complemented by reviewing reference lists of relevant papers.Study selectionOne investigator (T.H.) performed a preliminary scan of titles and abstracts for eligibility according to predefined inclusion criteria. Final decisions, for confirmation or in cases of uncertainty, were resolved in discussion with a second investigator (H.B.T). Title and abstracts from supplementary searches, identified by A.B. were examined by both the investigators (T.H. and H.B.T.) and an authoritative decision on inclusion was made jointly according to the original inclusion criteria. Once all potentially relevant full-text articles and abstracts were identified, we alpha-Amanitin web consulted as a team (T.H., H.B.T., A.B.) to achieve consensus regarding final eligibility.Methods Search strategyThe P-population I-Intervention C-Comparator O-Outcome framework is commonly used for determining inclusion and exclusion criteria for systematic reviews of quantitative studies [12]. For this review of qualitative data, a counterpart labelled as the `SPICE framework’ [13] was modified to formulate the review question. SPICE stands for S-setting, P-perspective, I-intervention, C-comparator and E-evaluation and specifies the key attributes of the review question (Table 1). We developed a highly sensitive search strategy combining key terms that may indicate the use of isoniazid (e.g. isoniazid/e), combined with the concept of adherence (e.g. adheren* OR complian*) and with an indicator of data required (e.g. qualitative OR findings OR interview*). This broad search strategy for qualitative data has been shown to perform acceptably when compared with more exhaustive lists of qualitative terms [14,15]. Because the search was intended to be as sensitive as possible we did not restrict by population at the AG-490 site searching stage. Instead we established an explicit association of relevant papers with both HIV/AIDS and TB when sifting by title and abstract. Initial searches were devel.Oint United Nations Programme on HIV/AIDS (UNAIDS) to enable the effective prevention, diagnosis and treatment of TB in PLWHAPLOS ONE | www.plosone.orgAdherence to Isoniazid Preventive Therapy[6,7,8]. The recommended regimen for TB preventive therapy in adolescents and adults is isoniazid (isonocotic acid hydrazide ?INH), 300 mg daily for at least 6 months [8,9]. A Cochrane review assessing the effectiveness of TB preventive therapy in reducing the risk of active TB and death in persons infected with HIV, `confirms that chemoprophylaxis with anti-tuberculosis drugs reduces the risk of clinical tuberculosis in HIV infected populations’ [10]. The review also cautions about the dangers of `poor adherence and drug resistant TB disease potentially associated with the use of long courses of isoniazid monotherapy’ [10]. Various health system related constraints have impeded the uptake of IPT. Only 12 of PLWHA who were newly enrolled in HIV care programmes were started on IPT, worldwide, in 2010 [1,9]. Adherence to treatment is a critical factor that needs to be considered in scaling up services in developing countries [9,10,11]. This paper seeks to systematically review the evidence on adherence to IPT with a view to assessing and interpreting deterrent and enabling factors associated with observed trends in non-adherence.Science and Google Scholar, identified two additional recent studies. The search strategy for MEDLINE on OvidSP is provided as supporting information: Ovid MEDLINE Search strategy, Table S1. Our search was complemented by reviewing reference lists of relevant papers.Study selectionOne investigator (T.H.) performed a preliminary scan of titles and abstracts for eligibility according to predefined inclusion criteria. Final decisions, for confirmation or in cases of uncertainty, were resolved in discussion with a second investigator (H.B.T). Title and abstracts from supplementary searches, identified by A.B. were examined by both the investigators (T.H. and H.B.T.) and an authoritative decision on inclusion was made jointly according to the original inclusion criteria. Once all potentially relevant full-text articles and abstracts were identified, we consulted as a team (T.H., H.B.T., A.B.) to achieve consensus regarding final eligibility.Methods Search strategyThe P-population I-Intervention C-Comparator O-Outcome framework is commonly used for determining inclusion and exclusion criteria for systematic reviews of quantitative studies [12]. For this review of qualitative data, a counterpart labelled as the `SPICE framework’ [13] was modified to formulate the review question. SPICE stands for S-setting, P-perspective, I-intervention, C-comparator and E-evaluation and specifies the key attributes of the review question (Table 1). We developed a highly sensitive search strategy combining key terms that may indicate the use of isoniazid (e.g. isoniazid/e), combined with the concept of adherence (e.g. adheren* OR complian*) and with an indicator of data required (e.g. qualitative OR findings OR interview*). This broad search strategy for qualitative data has been shown to perform acceptably when compared with more exhaustive lists of qualitative terms [14,15]. Because the search was intended to be as sensitive as possible we did not restrict by population at the searching stage. Instead we established an explicit association of relevant papers with both HIV/AIDS and TB when sifting by title and abstract. Initial searches were devel.
