Latent TB infection treatment acceptance and completion in the United States and Canada
| Autor: | C Robert, Horsburgh, Stefan, Goldberg, James, Bethel, Shande, Chen, Paul W, Colson, Yael, Hirsch-Moverman, Stephen, Hughes, Robin, Shrestha-Kuwahara, Timothy R, Sterling, Kirsten, Wall, Paul, Weinfurter, Mike, Jones |
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| Rok vydání: | 2009 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male Pediatrics medicine.medical_specialty Canada Tuberculosis Time Factors Adolescent Cross-sectional study Tuberculin Critical Care and Intensive Care Medicine law.invention Young Adult Randomized controlled trial law Latent Tuberculosis Outcome Assessment Health Care medicine Humans Child Aged Retrospective Studies Latent tuberculosis business.industry Retrospective cohort study Odds ratio Middle Aged Patient Acceptance of Health Care medicine.disease United States Regimen Cross-Sectional Studies Child Preschool Population Surveillance Patient Compliance Female Morbidity Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Chest. 137(2) |
| ISSN: | 1931-3543 |
| Popis: | Background Treatment of latent TB infection (LTBI) is essential for preventing TB in North America, but acceptance and completion of this treatment have not been systematically assessed. Methods We performed a retrospective, randomized two-stage cross-sectional survey of treatment and completion of LTBI at public and private clinics in 19 regions of the United States and Canada in 2002. Results At 32 clinics that both performed tuberculin skin testing and offered treatment, 123 (17.1%; 95% CI, 14.5%–20.0%) of 720 subjects tested and offered treatment declined. Employees at health-care facilities were more likely to decline (odds ratio [OR], 4.74; 95% CI, 1.75–12.9; P = .003), whereas those in contact with a patient with TB were less likely to decline (OR, 0.19; 95% CI, 0.07–0.50; P = .001). At 68 clinics starting treatment regardless of where skin testing was performed, 1,045 (52.7%; 95% CI, 48.5%–56.8%) of 1,994 people starting treatment failed to complete the recommended course. Risk factors for failure to complete included starting the 9-month isoniazid regimen (OR, 2.08; 95% CI, 1.23–3.57), residence in a congregate setting (nursing home, shelter, or jail; OR, 2.94; 95% CI, 1.58–5.56), injection drug use (OR, 2.13; 95% CI, 1.04–4.35), age ≥ 15 years (OR, 1.49; 95% CI, 1.14–1.94), and employment at a health-care facility (1.37; 95% CI, 1.00–1.85). Conclusions Fewer than half of the people starting treatment of LTBI completed therapy. Shorter regimens and interventions targeting residents of congregate settings, injection drug users, and employees of health-care facilities are needed to increase completion. |
| Databáze: | OpenAIRE |
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