title: Acceptance of treatment for latent tuberculosis infection: prospective cohort study in the United States and Canada.
abstract: METHODS
  An estimated 300 000 individuals are treated for latent tuberculosis infection (LTBI) in the United States and Canada annually. Little is known about the proportion or characteristics of those who decline treatment.
  
  
  OBJECTIVE
  To define the proportion of individuals in various groups who accept LTBI treatment and to identify factors associated with non-acceptance of treatment.
  
  
  METHODS
  Persons offered LTBI treatment at 30 clinics in 12 Tuberculosis Epidemiologic Studies Consortium sites were prospectively enrolled. Multivariate regression models were constructed based on manual stepwise assessment of potential predictors.
  
  
  RESULTS
  Of 1692 participants enrolled from March 2007 to September 2008, 1515 (89.5%) accepted treatment and 177 (10.5%) declined. Predictors of acceptance included believing one could personally spread TB germs, having greater TB knowledge, finding clinic schedules convenient and having low acculturation. Predictors of non-acceptance included being a health care worker, being previously recommended for treatment and believing that taking medicines would be problematic.
  
  
  CONCLUSIONS
  This is the first prospective multisite study to examine predictors of LTBI treatment acceptance in general clinic populations. Greater efforts should be made to increase acceptance among health care workers, those previously recommended for treatment and those who expect problems with LTBI medicines. Ensuring convenient clinic schedules and TB education to increase knowledge could be important for ensuring acceptance.
authors.affiliation: Charles P Felton National Tuberculosis Center, International Center for AIDS Care and Treatment Programs, Columbia University, New York, New York 10027, USA. pwc2@columbia.edu
authors.forename: P W
authors.initials: PW
authors.lastname: Colson
authors.forename: Y
authors.initials: Y
authors.lastname: Hirsch-Moverman
authors.forename: J
authors.initials: J
authors.lastname: Bethel
authors.forename: P
authors.initials: P
authors.lastname: Vempaty
authors.forename: K
authors.initials: K
authors.lastname: Salcedo
authors.forename: K
authors.initials: K
authors.lastname: Wall
authors.forename: W
authors.initials: W
authors.lastname: Miranda
authors.forename: S
authors.initials: S
authors.lastname: Collins
authors.forename: C R
authors.initials: CR
authors.lastname: Horsburgh
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D002170:Canada / Q000453:epidemiology; D016009:Chi-Square Distribution; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011446:Prospective Studies; D012307:Risk Factors; D016312:Treatment Refusal; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents