Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy

Tropical Medicine and Infectious Disease

article

Hashem Bishara¹  Manfred Green²  Amer Saffouri³  Daniel Weiler-Ravell⁴ 

[1] Tuberculosis Clinic and Pulmonary Division, Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar-Ilan University;School of Public Health, Faculty of Social Welfare and Health Science, University of Haifa;Tuberculosis Clinic and Internal Medicine, Nazareth Hospital, and Azrieli Faculty of Medicine, Bar-Ilan University;Former Director of Pulmonary Division and Tuberculosis Clinic, Carmel Medical Center

关键词: latent tuberculosis;    immigrants;    treatment;    preventive therapy;    reception centers;    Ethiopian;    cost;    treatment completion;   

DOI  :  10.3390/tropicalmed8020123

学科分类：社会科学、人文和艺术（综合）

来源: mdpi

【 摘 要 】

Background: The treatment of latent tuberculosis infection (LTBI) among high-risk populations is an essential component of Tuberculosis (TB) elimination. However, non-compliance with LTBI treatment remains a major obstacle hindering TB elimination efforts. We have previously reported high treatment compliance with nurse-managed, twice-weekly, directly observed Isoniazid treatment (DOT) for LTBI among hard-to-reach Ethiopian immigrants (EI’s). Objectives: to compare rate of completion of treatment, cost, and major adverse drug events with daily self-administered Isoniazid treatment (SAT) to nurse-managed Isoniazid DOT among hard-to-reach EIs. Materials and Methods: We conducted a retrospective study and compared self-administered LTBI treatment outcomes among EIs housed in reception centers during 2008–2012 to EIs treated with DOT. Results: Overall, 455 EIs were included (231 DOT, 224 SAT) in the study. We found no significant difference in treatment completion rates between the two groups (93.0% DOT vs. 87.9% SAT, p = 0.08). However, cases of grade III, drug-induced hepatitis were significantly fewer and treatment costs were significantly lower with the nurse–managed DOT compared with SAT (0% vs. 2.2%, p = 0.028, 363 vs. 521 United States Dollars, p < 0.001, respectively). Conclusions: Nurse-managed, twice-weekly DOT among hard-to-reach EIs housed in reception centers had less severe drug-related adverse events and reduced treatment cost compared with daily isoniazid SAT, yet we found no significant difference in treatment completion between the two strategies in this population.

【 授权许可】

CC BY