Acceptance of treatment for latent tuberculosis infection: prospective cohort study in the United States and Canada
Abstract:SETTING: An estimated 300 000 individuals are treated for latent tuberculosis infection (LTBI) in the United States and Canada annually. Little is known about the proportion or characteristics of those who decline treatment.
OBJECTIVE: To define the proportion of individuals in various groups who accept LTBI treatment and to identify factors associated with non-acceptance of treatment.
DESIGN: Persons offered LTBI treatment at 30 clinics in 12 Tuberculosis Epidemiologic Studies Consortium sites were prospectively enrolled. Multivariate regression models were constructed based on manual stepwise assessment of potential predictors.
RESULTS: Of 1692 participants enrolled from March 2007 to September 2008, 1515 (89.5%) accepted treatment and 177 (10.5%) declined. Predictors of acceptance included believing one could personally spread TB germs, having greater TB knowledge, finding clinic schedules convenient and having low acculturation. Predictors of non-acceptance included being a health care worker, being previously recommended for treatment and believing that taking medicines would be problematic.
CONCLUSION: This is the first prospective multisite study to examine predictors of LTBI treatment acceptance in general clinic populations. Greater efforts should be made to increase acceptance among health care workers, those previously recommended for treatment and those who expect problems with LTBI medicines. Ensuring convenient clinic schedules and TB education to increase knowledge could be important for ensuring acceptance.
Document Type: Research Article
Affiliations: 1: Charles P Felton National Tuberculosis Center, International Center for AIDS Care and Treatment Programs, Columbia University, New York, New York, USA 2: Westat, Rockville, Maryland, USA 3: Centers for Disease Control and Prevention, Atlanta, Georgia, USA 4: Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, California, USA 5: Denver Public Health & Hospitals Authority, Denver, Colorado, USA 6: New York State Department of Health, Albany, New York, USA 7: Maryland Department of Health & Mental Hygiene, Baltimore, Maryland, USA 8: Boston University School of Public Health, Boston, Massachusetts, USA
Publication date: April 1, 2013
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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