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Chest Infections |

Comparison of Treatment Compliance for Latent Tuberculosis (TB) Infection Among Patients of an Urban Chicago Community

Hasnain Bawaadam*, MD; Chris Caudill, MPH; Judith Beison, BS; Ashok Fulambarker; Rashid Nadeem, MD
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Rosalind Franklin University of Medicine and Science, North Chicago, IL


Chest. 2012;142(4_MeetingAbstracts):200A. doi:10.1378/chest.1366833
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Abstract

SESSION TYPE: Respiratory Infections Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: TB affects a third of world population. Latent TB infection (LTBI) is risk factor for TB disease. Prophylactic treatment with 9 months of Isoniazid (9H) has limited success because of longer duration. Rifampin for 4-month (4R) as an alternative acceptable regimen could help improve compliance. We compare the pattern of completion of these two regimens among patients of Cook County in Chicago, Illinois

METHODS: Medical records of 400 patients placed on LTBI treatment (RIF or INH) during 2004 were reviewed. A retrospective chart review was performed to identify contacts of TB disease cases that were tested positive by PPD and received treatment for LTBI. Parameters; age, gender, race, treatment start date and discontinuation date were recorded. Fisher’s exact tests, two-sample t-tests, and logistic regression were used to analyze the data.

RESULTS: There was no significant difference between completion rates for INH (73%) and RIF (73%), and this result remains non-significant when correcting for age, gender and race using linear regression (p>0.05). The only variable that was significantly different for the overall sample (N=400) was age (p=0.0005). Patients under 20 years of age had higher completion rates (84.0%) than either the 20-49 age group (68.0%) or 50+ age group (63.0%)(p<.0005). Within the INH treatment group there was a significant difference between racial groups, gender, and age for completion rates with the Hispanic group 3.47(1.43-8.39) times more likely to complete than African Americans and the less than 20 age group 4.68(1.36-16.11) more likely than the >50 group to complete the 9 month INH treatment than others. Females had higher treatment rates than males in the 9H group, 78% vs. 65% (p<.05).

CONCLUSIONS: Although overall treatment completion rates for LTBI are similar for 4 months of RIF and 9 months of INH, African American patients receiving 4R were significantly more likely to complete therapy than those receiving 9H and younger patients (less than 20) did far better than others within the 9H group.

CLINICAL IMPLICATIONS: Larger studies are warranted to observe this compliance profile which may help optimize treatment completion rates for LTBI.

DISCLOSURE: The following authors have nothing to disclose: Hasnain Bawaadam, Chris Caudill, Judith Beison, Ashok Fulambarker, Rashid Nadeem

No Product/Research Disclosure Information

Rosalind Franklin University of Medicine and Science, North Chicago, IL

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