Document Type

Master's Culminating Experience

Publication Date

2013

Abstract

In Peru, treatment for latent tuberculosis infection (LTBI) with isoniazid is free for all people younger than 20 who have been in close contact with a person with active pulmonary tuberculosis (TB). Despite the availability of this drug therapy within the context of a TB control program that exceeds the international standards for TB care, very few children access, and even fewer complete a full course of treatment. This study was done in order to understand which factors contribute to latent tuberculosis infection treatment uptake and adherence, and whether a socio-economic intervention could improve uptake and adherence of treatment for latent tuberculosis infection. The research was based on data collected from 2007-2011 in a large periurban shantytown outside of Lima, Peru. The data were from a large cluster randomized controlled trial called Innovative Socio-economic Interventions Against Tuberculosis (ISIAT). First, a large database of TB treatment cards was analyzed for LTBI treatment uptake and utilization in individual contacts in the monitoring (control) group (n=3226). Age range of contact, crowding in household, index case place of origin, index case abandonment, and time established in Lima were all significant risk factors for uptake and adherence of LTBI treatment. Uptake and adherence were also analyzed with respect to the intervened (n=617) versus the control arm of the study. In the intervened areas, contacts were 1.74 times (95% CI [1.59, 1.87], p <0.001) as likely to start, and 2.64 times (95%CI [2.27, 3.07], p<0.001) as likely to complete LTBI treatment.


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