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Free Content Cultural case management of latent tuberculosis infection

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Abstract:

SETTING: The proportion of tuberculosis (TB) among foreign-born individuals in the United States is steadily increasing. Treatment of latent TB infection can prevent future cases of disease, although generally only 60% of patients who start a 6-month regimen of isoniazid complete therapy.

OBJECTIVE: Cultural case management—employing case manager cultural mediators who serve patient-defined needs in addition to performing TB control functions—may improve results of testing and treatment in one high-risk group, new refugees.

DESIGN: A cultural case management approach was established for finding and treating latent TB infection among three groups of new refugees: from the former Soviet Union (FSU), former Yugoslavia (FY), and Somalia.

RESULTS: From July 1999 through December 2000, treatment was offered to 442 refugees, of whom 389 (88%) started and 319 (82%) completed therapy. The completion rate among starters from the FSU was 76%, for those from FY it was 94% and for those from Somalia it was 88%. Among all refugees to whom treatment was offered, 319/442 (72%) completed therapy.

CONCLUSION: Cultural case management may be a useful tool for expanding treatment of latent TB infection among foreign-born individuals.

Keywords: case management; refugees; tuberculosis; tuberculosis infection

Document Type: Regular Paper

Affiliations: 1: TB Control Program, Public Health—Seattle & King County, Seattle, Washington, USA 2: TB Control Program, Public Health—Seattle & King County, Seattle, Washington, USA; and University of Washington, Harborview Medical Center, Seattle, Washington, USA 3: University of Washington, Harborview Medical Center, Seattle, Washington, USA 4: Annie E Casey Foundation, Baltimore, Maryland, USA

Publication date: 2004-01-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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