Urine testing to monitor adherence to TB preventive therapy.
This study examined the validity of the Arkansas urine test. One hundred ninety-four adolescents submitted an unannounced urine specimen monthly (for 6 to 8 months). Duplicate specimens were blindly tested with high agreement (kappa >90%). Sensitivity and specificity were estimated. In 68% of test runs, adolescents recalled taking INH within 24 hr of specimen collection. For recall intervals of 24, 48, and 72 hr, sensitivity was 87, 85, and 83%, respectively. Females were less likely to test positive when INH was taken within the previous 24 hr (sensitivity 84 versus 92% males). Specificity was 57, 91, and 95% at 24, 48, and 72 hr, respectively. The Arkansas urine test was practical to use, and results correlated well with self-reported adherence to INH for treatment of latent tuberculosis infection (LTBI), over several months of follow-up. The test may be useful as part of an adherence-monitoring program when used in conjunction with self-reported measures.
Perry
Sharon
S
University of California San Francisco, San Francisco, CA, USA.
Hovell
Melbourne F
MF
Blumberg
Elaine
E
Berg
Jill
J
Vera
Alicia
A
Sipan
Carol
C
Kelley
Norma
N
Moser
Kathleen
K
Catanzaro
Antonino
A
Friedman
Larry
L
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use* / Q000652:urine*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use* / Q000652:urine*; D008297:Male; D010349:Patient Compliance; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000517:prevention & control*
D000995:Antitubercular Agents; D007538:Isoniazid