Risk factors for failure to complete a course of latent tuberculosis infection treatment in Salvador, Brazil
OBJECTIVE: To examine the practice of and adherence to LTBI treatment in a high-risk population in Brazil.
DESIGN: We followed household contacts (HHCs) of patients hospitalized with pulmonary TB in Salvador, Brazil, for 6 months after they initiated LTBI treatment with isoniazid (INH). HHCs were asked to return to the hospital once a month for 6 months for follow-up visits and INH refills.
RESULTS: Of 101 HHCs who initiated LTBI treatment, 54 (53.5%) completed the 6-month regimen. The risk of treatment non-completion was significantly higher in HHCs who reported side effects to INH (RR 2.69, 95%CI 1.3–5.8, P = 0.01), and in those who had to take two buses for a one-way trip to the hospital (RR 1.8, 95%CI 1.01–3.3, P = 0.04). Of the 101 HHCs, 29 (28.7%) did not return for any follow-up visits; these HHCs were significantly more likely to have a 2-bus commute to the hospital compared to HHCs who completed treatment (OR 20.69, 95%CI 2.1–208.4, P = 0.01).
CONCLUSION: Nearly 50% of HHCs at high risk for developing TB completed a 6-month course of LTBI treatment. Completion of LTBI treatment was most affected by medication intolerance and commuting difficulties for follow-up visits.
Document Type: Regular Paper
Affiliations: 1: Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil; Hospital Especializado Octávio Mangabeira, Salvador, Bahia, Brazil 2: School of Public Health, University of California, Berkeley, California, USA 3: Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil 4: Laboratório Integrado de Microbiologia e Imunorregulação, Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia, Brazil 5: Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil; and Laboratório de Patologia e Biologia Molecular, Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia, Brazil 6: Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil; and Laboratório Avançado de Saúde Pública, Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia, Brazil
Publication date: June 1, 2009
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