SETTING: A community-based directly observed preventive therapy (DOPT) program for treatment of latent tuberculosis infection among injection drug users (IDUs) in an inner-city neighborhood. OBJECTIVE: To test adherence to a 6-month course of DOPT using cash incentives and an easily accessible neighborhood location. DESIGN: Street-recruited IDUs (N = 205) were screened for Mycobacterium tuberculosis (TB) infection using the Mantoux test and two controls. Subjects who had a purified protein derivative (PPD) reaction of > or =5 mm, were anergic, or had a history of a positive PPD received clinical evaluation at a community field site, provided in collaboration with the San Francisco Department of Public Health Tuberculosis Clinic. Twenty-eight subjects were considered appropriate candidates for prophylaxis with isoniazid, and 27 enrolled in the pilot study. Participants received twice-weekly DOPT at a community satellite office, with a $10 cash incentive at each visit. RESULTS: The 6-month (26-week) regimen was completed by 24/27 (89%) participants. The median time to treatment completion was 27 weeks (range 26 to 34 weeks). The median proportion of dosing days attended in 6 months was 96%. CONCLUSION: Community-based DOPT using cash incentives resulted in high levels of adherence and treatment completion among drug users.
SETTING: A community-based directly observed preventive therapy (DOPT) program for treatment of latent tuberculosis infection among injection drug users (IDUs) in an inner-city neighborhood. OBJECTIVE: To test adherence to a 6-month course of DOPT using cash incentives and an easily accessible neighborhood location. DESIGN: Street-recruited IDUs (N = 205) were screened for Mycobacterium tuberculosis (TB) infection using the Mantoux test and two controls. Subjects who had a purified protein derivative (PPD) reaction of > or =5 mm, were anergic, or had a history of a positive PPD received clinical evaluation at a community field site, provided in collaboration with the San Francisco Department of Public Health Tuberculosis Clinic. Twenty-eight subjects were considered appropriate candidates for prophylaxis with isoniazid, and 27 enrolled in the pilot study. Participants received twice-weekly DOPT at a community satellite office, with a $10 cash incentive at each visit. RESULTS: The 6-month (26-week) regimen was completed by 24/27 (89%) participants. The median time to treatment completion was 27 weeks (range 26 to 34 weeks). The median proportion of dosing days attended in 6 months was 96%. CONCLUSION: Community-based DOPT using cash incentives resulted in high levels of adherence and treatment completion among drug users.
Authors: Ricky N Bluthenthal; D Phuong Do; Brian Finch; Alexis Martinez; Brian R Edlin; Alex H Kral Journal: J Urban Health Date: 2007-07-27 Impact factor: 3.671
Authors: Brian R Edlin; Thomas F Kresina; Daniel B Raymond; Michael R Carden; Marc N Gourevitch; Josiah D Rich; Laura W Cheever; Victoria A Cargill Journal: Clin Infect Dis Date: 2005-04-15 Impact factor: 9.079
Authors: David C Perlman; Patricia Friedmann; Leslie Horn; Anne Nugent; Veronika Schoeb; Jeanne Carey; Nadim Salomon; Don C Des Jarlais Journal: J Urban Health Date: 2003-09 Impact factor: 3.671
Authors: Melbourne F Hovell; Carol L Sipan; Elaine J Blumberg; C Richard Hofstetter; Donald Slymen; Lawrence Friedman; Kathleen Moser; Norma J Kelley; Alicia Y Vera Journal: Am J Public Health Date: 2003-11 Impact factor: 9.308