title: [Accessibility and compliance of Ethiopian immigrants to latent tuberculosis infection treatment].
abstract: BACKGROUND
  Since the incidence of TB has decreased in the developed countries, the diagnosis and treatment of latent TB infection (LTBI) has assumed increasing importance. It is estimated that 5-10% of persons with LTBI go on to develop TB; therefore, the crucial role of LTBI treatment in eliminating TB is well recognized. However, levels of adherence are found to be consistently low, and noncompliance constitutes the major barrier for achieving the full benefits of LTBI treatment.
  
  
  OBJECTIVE
  1. To estimate rates of treatment completion with an outreach - directly observed preventive treatment (DOPT), a program among Ethiopian immigrants (El) at absorption centers treated for LTBI. 2. To determine if follow-up visits by a physician at their place of residence, vs. management at a TB Clinic (TBC), would further enhance the patient's adherence.
  
  
  METHODS
  Quasi experiment, retrospective cohort analysis of 495 medical records for all El at absorption centers in Zefat who had started DOPT for LTBI and were followed up at absorption centers (2005-2006, study group - SG), compared to patients followed up at a TBC (2008-2010, comparison group - CG). Free transportation to the TBC was provided for the CG.
  
  
  RESULTS
  Altogether 495 Els were included (263 in the SG and 232 in the CG group). Both groups had high completion rates (SG: 96.2% vs. CG: 93.1%, p=0.14). While demographic factors did not predict treatment completion, side effects were significantly associated with non-completion.
  
  
  CONCLUSIONS
  High treatment completion rates among El were achieved when DOPT outreach and cultural case management strategies were combined. In these circumstances, the physician follow-up location had no significant impact on treatment completion rates.
authors.affiliation: Tuberculosis Clinic, Nazereth Hospital, Faculty of Medicine, Bar Ilan University, Galilee. hashimbishara@nazhosp.com
authors.forename: Hashem
authors.initials: H
authors.lastname: Bishara
authors.affiliation: School of Public Health, Faculty of Social Welfare and Health Science, University of Haifa.
authors.forename: Liora
authors.initials: L
authors.lastname: Ore
authors.affiliation: Tuberculosis Clinic, Nazereth Hospital, Faculty of Medicine, Bar Ilan University, Galilee.
authors.forename: Haya
authors.initials: H
authors.lastname: Bshara
authors.affiliation: Ministry of Health, Northern District.
authors.forename: Olga
authors.initials: O
authors.lastname: Vinitsky
authors.affiliation: Tuberculosis Clinic, Nazereth Hospital, Faculty of Medicine, Bar Ilan University, Galilee.
authors.forename: Najat
authors.initials: N
authors.lastname: Armaly
authors.affiliation: Tuberculosis Clinic, Nazereth Hospital, Faculty of Medicine, Bar Ilan University, Galilee.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weiler-Ravell
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D023801:Directly Observed Therapy / Q000379:methods; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D007557:Israel; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D014186:Transportation; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000995:Antitubercular Agents