Risk factors for failure to complete a course of latent tuberculosis infection treatment in Salvador, Brazil.
BACKGROUND
Although treatment of latent tuberculosis infection (LTBI) is an essential component of tuberculosis (TB) control in countries such as the United States, it is not widely practiced in most TB-endemic countries.


OBJECTIVE
To examine the practice of and adherence to LTBI treatment in a high-risk population in Brazil.


METHODS
We followed household contacts (HHCs) of patients hospitalized with pulmonary TB in Salvador, Brazil, for 6 months after they initiated LTBI treatment with isoniazid (INH). HHCs were asked to return to the hospital once a month for 6 months for follow-up visits and INH refills.


RESULTS
Of 101 HHCs who initiated LTBI treatment, 54 (53.5%) completed the 6-month regimen. The risk of treatment non-completion was significantly higher in HHCs who reported side effects to INH (RR 2.69, 95%CI 1.3-5.8, P = 0.01), and in those who had to take two buses for a one-way trip to the hospital (RR 1.8, 95%CI 1.01-3.3, P = 0.04). Of the 101 HHCs, 29 (28.7%) did not return for any follow-up visits; these HHCs were significantly more likely to have a 2-bus commute to the hospital compared to HHCs who completed treatment (OR 20.69, 95%CI 2.1-208.4, P = 0.01).


CONCLUSIONS
Nearly 50% of HHCs at high risk for developing TB completed a 6-month course of LTBI treatment. Completion of LTBI treatment was most affected by medication intolerance and commuting difficulties for follow-up visits.
Machado
Almério
A
Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil. almeriojr@yahoo.com.br
Finkmoore
B
B
Emodi
K
K
Takenami
I
I
Barbosa
T
T
Tavares
M
M
Reis
M G
MG
Arruda
S
S
Riley
L W
LW
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D011446:Prospective Studies; D012307:Risk Factors; D014186:Transportation; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D055815:Young Adult
D000995:Antitubercular Agents; D007538:Isoniazid