Treatment completion in latent tuberculosis infection at specialist tuberculosis units in Spain
Abstract:SETTING: Treatment of latent tuberculosis infection (LTBI) is essential for tuberculosis (TB) control in low-prevalence countries. However, the long treatment duration and adverse events frequently result in suboptimal treatment completion.
OBJECTIVE: To determine completion rates of LTBI treatment and to identify risk factors for non-completion of treatment.
DESIGN: Retrospective, observational cohort study.
METHODS: All non-human immunodeficiency virus infected adults who started treatment for LTBI at two specialist TB units in Spain between January 2004 and March 2007 were included. Those who discontinued treatment due to toxicity were excluded.
RESULTS: Of 599 people who started on treatment, 484 (80.8%, 95%CI 77.5–83.8) completed it. Age <36 years (OR 0.33, 95%CI 0.30–0.76, P = 0.001), male sex (OR 0.58, 95%CI 0.37–0.92, P = 0.02), immigrant status <5 years of residence (OR 0.21, 95%CI 0.12–0.37, P < 0.001) and the presence of social risk factors (OR 0.21, 95%CI 0.11–0.39, P < 0.001) were associated with lower rates of treatment completion. Short treatment regimens were not associated with better treatment completion compared with isoniazid for 6–9 months (OR 0.89, 95%CI 0.45–1.80, P = 0.76).
CONCLUSIONS: Overall, completion rates of LTBI treatment in specialist TB units are good. Nevertheless, counselling should be strengthened and new strategies to enhance adherence should be sought for recent immigrants and for people in unfavourable social situations.
Document Type: Regular Paper
Affiliations: 1: Tuberculosis Unit, Service of Internal Medicine, Complexo Hospitalario de Pontevedra, Pontevedra, Spain 2: Service of Preventive Medicine, Complexo Hospitalario de Pontevedra, Pontevedra, Spain 3: Department of Infectious Diseases, Clinical Tuberculosis Unit, Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
Publication date: June 1, 2010
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.
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