Authors:
Leonie Simo, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Simplice Lekeumo, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Tabiayuk Ayukotabe, Division for Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Joseph Fokam, Central Technical Group, National AIDS Control Committee, Ministry of Health, Yaoundé, Cameroon
Pierrette Omgba, Central Technical Group, National AIDS Control Committee, Ministry of Health, Yaoundé, Cameroon
Leonela Mossiang, Central Technical Group, National AIDS Control Committee, Ministry of Health, Yaoundé, Cameroon
Daniel Mabongo, Central Technical Group, National AIDS Control Committee, Ministry of Health, Yaoundé, Cameroon
Emile Nforbih Shu, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Salima Djamilatou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Arnaud Cedric Lacmago Kamta, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Martial Fabou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Rogacien Kana, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Yasmine Moussa Fadil, Division for Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Eunice Vanessa Yuego Chedjou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Colince Keleko, Division for Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Francis Bogni, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Boris Tchounga, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Irène Adeline Goupeyou Wandji, Regional Technical Group, National Tuberculosis Control Program, Delegation of Public Health, Douala, Cameroon
Jose Esther Lyonga, Division for Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Zachary Bissemou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Ebako Takem, Division for Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Gilles Ndayisaba, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Karin A. Bosh, Division for Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Patrice Tchendjou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé Cameroon
Introduction:
A short course regimen of isoniazid and rifapentine (3HP) was introduced in 2023 in Cameroon to improve tuberculosis preventive treatment (TPT) uptake and completion. However, following introduction in five pilot sites in 2024, suboptimal 3HP uptake (15%) was reported among eligible people living with HIV (PLHIV) at 13 months post introduction. We implemented a program optimization approach (POA) to improve 3HP uptake and completion in Littoral and South regions in Cameroon.
Methods:
Between March and September 2025, a POA was implemented following plan-do-study-act (PDSA) cycle method to improve 3HP uptake in five pilot facilities and to strengthen expansion of 3HP in nine scale-up facilities. In March, brainstorming sessions identified root causes of low uptake and completion during the pilot phase. The intervention package, initiated in April, included provider training, patient sensitization, strengthened supervision, and real-time clinical and stock monitoring. Data pre- and post-POA intervention were extracted from registers and electronic data sources for descriptive analysis.
Results:
In the five pilot facilities, 3HP uptake increased from 0% to 15% (488/3,166) between February 2024 and March 2025 (pre-POA intervention). Then 3HP uptake increased from 15% to 49% (1,536/3,166) during the first PDSA cycle (April-June 2025) and to 60% (1,914/3,166) during the second cycle (July-September 2025), giving an overall increase of +45% in six months. In the five pilot facilities, completion improved from 93% (317/439) before POA to 96% (1,203/1,254) at 6 months post POA intervention. In the nine scale up facilities, 3HP rollout during POA implementation resulted in a rapid increase of 3HP uptake from 0% to 30% (586/1,922) in six months, with 91% (475/520) completion rate.
Conclusions:
Substantive increases in 3HP uptake were observed during POA implementation in pilot and scale-up facilities. PDSA cycle method, coupled with well-designed and inclusive introduction approach could help improve TPT uptake among PLHIV.
