Directly observed preventive treatment (DOPT) for latent tuberculosis infection (LTBI) on completion
Background: Ethiopian immigrants (EI) at absorption centers treated for LTBI by DOPT, were followed on-site from 2005 - 2007 by a physician, to supposedly enhance compliance to therapy. This strategy could not be continued and between 2008-2010, patients were followed at a tuberculosis center (TBC) 60 Km. away, while DOPT was continued at the absorption center.
Objective: To compare completion rates and cost of DOPT among EI when managed at their place of residence vs. management at a TBC.
Methodology: A retrospective cohort analysis of 547 medical records for all EI at absorption centers in Zefat who had started DOPT for LTBI and were followed up at absorption centers (2005-2006, study group -SG), compared to patients followed up at a TBC (2008-2010, comparison group CG). Free transportation to the TBC was provided for the CG.
Findings: Altogether 495 EIs were included (263 in the SG and 232 in the CG group). Both groups had high completion rates (SG: 96.2% vs. CG: 93.1%, p=0.14). While demographic factors did not predict treatment completion side effects were significantly associated with non-completion. Costs were the same for both groups.
Conclusion: The success and cost of DOPT was not dependent on on-site physician involvement. High completion rates could be due to the congregation of immigrants in absorption centers leading to easy access to dedicated and skilled TB nursing staff.
Sponsored by the Israel National Institute for Health Policy Research and the Israel Lung and Tuberculosis Association.
Part of a Thesis submitted for MPH degree, School of Public Health, University of Haifa, Israel.
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