Predictors of latent tuberculosis infection treatment completion in the United States: an inner city experience.
BACKGROUND
Few studies have examined predictors of latent tuberculosis infection (LTBI) treatment completion in inner city populations in the United States.


OBJECTIVE
To assess LTBI treatment completion rates and predictors in an inner city cohort.


METHODS
Data from control groups of two sequentially conducted randomized controlled trials of LTBI treatment were analyzed for treatment completion rates. Participants in Study A (n = 191), conducted in 1996-1999, self administered daily isoniazid (INH) for 6-12 months, while participants in Study B (n = 123), conducted in 2002-2005, self administered daily INH for 9 months.


RESULTS
Overall, 44.6% of participants completed therapy, with significantly higher completion rates in Study B than Study A (37.0% vs. 56.1%, P = 0.001). Marriage and alcohol use were significant predictors of completion (aOR = 2.153, 95%CI 1.301-3.562) and non-completion (aOR = 0.530, 95%CI 0.320-0.877), respectively; multivariate analysis indicated increased completion among married persons of foreign birth and among alcohol users who were homeless. Knowledge of and attitudes to tuberculosis were not significant predictors.


CONCLUSIONS
The design provided an opportunity to assess predictors of LTBI treatment completion in this inner city population. Social circumstances were the strongest predictors of treatment completion, suggesting that tangible social services may be more effective than educational programs in encouraging treatment completion.
Hirsch-Moverman
Y
Y
Charles P Felton National Tuberculosis Center, International Center for AIDS Care and Treatment Programs, Mailman School of Public Health, Columbia University, New York, New York 10027, USA. yh154@columbia.edu
Bethel
J
J
Colson
P W
PW
Franks
J
J
El-Sadr
W
W
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D055985:Latent Tuberculosis / Q000188:drug therapy*; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data; D055118:Medication Adherence; D015999:Multivariate Analysis; D016032:Randomized Controlled Trials as Topic; D012646:Self Administration; D012931:Social Environment; D014481:United States; D014504:Urban Health
D000995:Antitubercular Agents; D007538:Isoniazid
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