Yisi Liu1, Stephen Birch2,3, K Bruce Newbold4, Beverley M Essue2,5. 1. Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA. 2. Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. 3. Centre for Health Economics, University of Manchester, Manchester, UK. 4. School of Geography and Earth Sciences, McMaster University, Ontario, Canada. 5. University of Sydney, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES: We investigated the rates of initiation and completion of treatment for latent TB infection (LTBI), factors explaining nonadherence and interventions to improve treatment adherence in countries with low TB incidence. DESIGN: A systematic search was performed in PubMed and Embase. All included articles were assessed for risk of bias. A narrative synthesis of the results was conducted. RESULTS: There were 54 studies included in this review. The proportion of people initiating treatment varied from 24% to 98% and the proportion of people completing treatment varied from 19% to 90%. The main barriers to adherence included the fear or experience of adverse effects, long duration of treatment, financial barriers, lack of transport to clinics (for patients), and insufficient resources for LTBI control. While interventions like peer counseling, incentives, and culturally specific case management have been used to improve adherence, the proportion of people who initiate and complete LTBI treatment still remains low. CONCLUSION: To further improve treatment and LTBI control and to fulfill the World Health Organization goal of eliminating TB in low-incidence countries, greater priority should be given to the use of treatment regimens involving shorter durations and fewer adverse effects, like the 3-month regimen of weekly rifapentine plus isoniazid, supported by innovative patient education and incentive strategies.
OBJECTIVES: We investigated the rates of initiation and completion of treatment for latent TB infection (LTBI), factors explaining nonadherence and interventions to improve treatment adherence in countries with low TB incidence. DESIGN: A systematic search was performed in PubMed and Embase. All included articles were assessed for risk of bias. A narrative synthesis of the results was conducted. RESULTS: There were 54 studies included in this review. The proportion of people initiating treatment varied from 24% to 98% and the proportion of people completing treatment varied from 19% to 90%. The main barriers to adherence included the fear or experience of adverse effects, long duration of treatment, financial barriers, lack of transport to clinics (for patients), and insufficient resources for LTBI control. While interventions like peer counseling, incentives, and culturally specific case management have been used to improve adherence, the proportion of people who initiate and complete LTBI treatment still remains low. CONCLUSION: To further improve treatment and LTBI control and to fulfill the World Health Organization goal of eliminating TB in low-incidence countries, greater priority should be given to the use of treatment regimens involving shorter durations and fewer adverse effects, like the 3-month regimen of weekly rifapentine plus isoniazid, supported by innovative patient education and incentive strategies.
Authors: Mario Martin-Sanchez; Silvia Brugueras; Anna de Andrés; Pere Simon; Pilar Gorrindo; Miriam Ros; Eva Masdeu; Joan-Pau Millet; Joan A Caylà; Àngels Orcau Journal: PLoS One Date: 2019-04-15 Impact factor: 3.240
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Authors: G G Alvarez; D Van Dyk; R Mallick; S Lesperance; P Demaio; S Finn; S Edmunds Potvin; M Patterson; C Pease; K Amaratunga; C Hui; D W Cameron; S Mulpuru; S D Aaron; F Momoli; A Zwerling Journal: Int J Circumpolar Health Date: 2020-12 Impact factor: 1.228