Isoniazid prophylaxis for tuberculosis prevention among HIV infected police officers in Dar es Salaam

Objective: To determine the acceptability, compliance and side effects of i soniazid (INH) prophylaxis against tuberculosis among HIV infected police o fficers (PO) in Dar es Salaam. Design: A nested study from a prospective follow up of a cohort of police o fficers. Setting: Dar es Salaam, Tanzania, Subjects: One hundred and forty three HIV-1 infected police officers, Main outcome measures: Acceptance and compliance to INH prophylaxis. Results: Of the 400 HIV-1 infected officers, 143 (35.7%) came forward for p ost-test counselling and HIV test results. Sixty per cent (87/143) of them accepted to be on INH prophylaxis. However only 42.5% (37/87) came forward for evaluation regarding their suitability for INH prophylaxis. During the evaluation, eight (21.6%) of 37 otherwise asymptomatic PO were found to hav e active pulmonary tuberculosis (TB), Eventually only 29 PO were actually s tarted on INH, and only 16 (55.2 %) of them completed the six months course . No serious side effects were observed, One PO developed TB two months aft er loss to follow up before completing the six months. Conclusions: There was low acceptability of and poor compliance with INH pr ophylaxis among the HIV-1 infected PO despite being educated on the benefit s of prophylaxis. The prevalence of PTB among asymptomatic HIV-1 infected P O was high, and therefore persons with HIV infection should be examined for TB even in the absence of symptoms.