TABLE 1.

Example Barriers and Interventions in TPT Scale-Up Among PLHIV in CDC-Supported Sites—Nigeria, 2018–2019

Section(s) of Tool	Example Barrier Identified	Example Intervention
Clinical training, community education, and patient management	Clinician concerns about effectiveness of TPT, potential resistance to FNH, and TPT-related adverse events	Sensitization of clinicians through direct mentorship and education sessions on benefits of TPT, effective TPT pretreatment counseling, management of adherence, and TPT-related adverse events
Community education	Lack of TPT demand from patients	Demand creation through convening patient education seminars in the waiting room on clinic days
Patient management	Lack of clinician prescribing of TPT	Periodic audit of all medical files of PLHIV seeking care to note eligibility for TPT
		Periodic reviews of patient-level TPT form and site-level TPT register
		Dissemination of TPT algorithms and job aids Use of a checklist to identify TPT eligibility, adverse events, and outcome
Commodities and logistics management	Forecasting and ordering of INH for TPT based on historic use rather than planned scale-up	Kitting of INH for each PLHIV initiating TPT to ensure supply
		Linking TPT pickup with ART pickup to forecast numbers of TPT courses needed
Recording and reporting TPT initiations	Inconsistent recording or use of nonstandard indicators	Dissemination and training on correctly filling nationally standardized TPT monitoring and evaluation tools