Authors: Pritchett, E.N.¹; Schlossberg, D.¹; Lovett-Glenn, G.¹; Beck, J.²; Dickman, B.¹

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 3, March 2009 , pp. 323-327(5)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

BACKGROUND: The Philadelphia Department of Public Health Tuberculosis (TB) Control Program has a progressively severe, stepwise legal process for managing non-adherent TB patients, potentially culminating in incarceration.

OBJECTIVE: To review the application of legal procedures and to evaluate their effectiveness in the management of non-adherent TB patients.

METHODS: We evaluated this process by reviewing patients' records from 2001 to 2005 to identify all non-adherent patients and determine their treatment outcomes.

RESULTS: In this period, we initiated the legal process for 39 non-adherent patients. One patient died, and nine patients were lost. Twenty-nine patients became adherent after the use of a legal intervention. Our final completion percentage was 76.3%.

CONCLUSION: Our legal process improved the treatment completion rate for patients who would otherwise have been non-adherent. Increasing treatment completion rates reduce the risk of relapse and disease transmission as well as the growing rate of anti-tuberculosis drug resistance.

Keywords: tuberculosis; non-adherence; legal; confinement

Document Type: Regular paper

Affiliations: 1: Tuberculosis Control Program, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA 2: Tuberculosis Control Program, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA; and Association of Public Health Laboratories, Silver Spring, Maryland, USA

Publication date: 2009-03-01

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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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