Cargando…

Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy

Background: The treatment of latent tuberculosis infection (LTBI) among high-risk populations is an essential component of Tuberculosis (TB) elimination. However, non-compliance with LTBI treatment remains a major obstacle hindering TB elimination efforts. We have previously reported high treatment...

Descripción completa

Detalles Bibliográficos
Autores principales: Bishara, Hashem, Green, Manfred, Saffouri, Amer, Weiler-Ravell, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964860/
https://www.ncbi.nlm.nih.gov/pubmed/36828539
http://dx.doi.org/10.3390/tropicalmed8020123
_version_ 1784896613472272384
author Bishara, Hashem
Green, Manfred
Saffouri, Amer
Weiler-Ravell, Daniel
author_facet Bishara, Hashem
Green, Manfred
Saffouri, Amer
Weiler-Ravell, Daniel
author_sort Bishara, Hashem
collection PubMed
description Background: The treatment of latent tuberculosis infection (LTBI) among high-risk populations is an essential component of Tuberculosis (TB) elimination. However, non-compliance with LTBI treatment remains a major obstacle hindering TB elimination efforts. We have previously reported high treatment compliance with nurse-managed, twice-weekly, directly observed Isoniazid treatment (DOT) for LTBI among hard-to-reach Ethiopian immigrants (EI’s). Objectives: to compare rate of completion of treatment, cost, and major adverse drug events with daily self-administered Isoniazid treatment (SAT) to nurse-managed Isoniazid DOT among hard-to-reach EIs. Materials and Methods: We conducted a retrospective study and compared self-administered LTBI treatment outcomes among EIs housed in reception centers during 2008–2012 to EIs treated with DOT. Results: Overall, 455 EIs were included (231 DOT, 224 SAT) in the study. We found no significant difference in treatment completion rates between the two groups (93.0% DOT vs. 87.9% SAT, p = 0.08). However, cases of grade III, drug-induced hepatitis were significantly fewer and treatment costs were significantly lower with the nurse–managed DOT compared with SAT (0% vs. 2.2%, p = 0.028, 363 vs. 521 United States Dollars, p < 0.001, respectively). Conclusions: Nurse-managed, twice-weekly DOT among hard-to-reach EIs housed in reception centers had less severe drug-related adverse events and reduced treatment cost compared with daily isoniazid SAT, yet we found no significant difference in treatment completion between the two strategies in this population.
format Online
Article
Text
id pubmed-9964860
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99648602023-02-26 Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy Bishara, Hashem Green, Manfred Saffouri, Amer Weiler-Ravell, Daniel Trop Med Infect Dis Brief Report Background: The treatment of latent tuberculosis infection (LTBI) among high-risk populations is an essential component of Tuberculosis (TB) elimination. However, non-compliance with LTBI treatment remains a major obstacle hindering TB elimination efforts. We have previously reported high treatment compliance with nurse-managed, twice-weekly, directly observed Isoniazid treatment (DOT) for LTBI among hard-to-reach Ethiopian immigrants (EI’s). Objectives: to compare rate of completion of treatment, cost, and major adverse drug events with daily self-administered Isoniazid treatment (SAT) to nurse-managed Isoniazid DOT among hard-to-reach EIs. Materials and Methods: We conducted a retrospective study and compared self-administered LTBI treatment outcomes among EIs housed in reception centers during 2008–2012 to EIs treated with DOT. Results: Overall, 455 EIs were included (231 DOT, 224 SAT) in the study. We found no significant difference in treatment completion rates between the two groups (93.0% DOT vs. 87.9% SAT, p = 0.08). However, cases of grade III, drug-induced hepatitis were significantly fewer and treatment costs were significantly lower with the nurse–managed DOT compared with SAT (0% vs. 2.2%, p = 0.028, 363 vs. 521 United States Dollars, p < 0.001, respectively). Conclusions: Nurse-managed, twice-weekly DOT among hard-to-reach EIs housed in reception centers had less severe drug-related adverse events and reduced treatment cost compared with daily isoniazid SAT, yet we found no significant difference in treatment completion between the two strategies in this population. MDPI 2023-02-16 /pmc/articles/PMC9964860/ /pubmed/36828539 http://dx.doi.org/10.3390/tropicalmed8020123 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Bishara, Hashem
Green, Manfred
Saffouri, Amer
Weiler-Ravell, Daniel
Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy
title Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy
title_full Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy
title_fullStr Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy
title_full_unstemmed Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy
title_short Latent Tuberculosis Treatment among Hard-to-Reach Ethiopian Immigrants: Nurse-Managed Directly Observed versus Self-Administered Isoniazid Therapy
title_sort latent tuberculosis treatment among hard-to-reach ethiopian immigrants: nurse-managed directly observed versus self-administered isoniazid therapy
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964860/
https://www.ncbi.nlm.nih.gov/pubmed/36828539
http://dx.doi.org/10.3390/tropicalmed8020123
work_keys_str_mv AT bisharahashem latenttuberculosistreatmentamonghardtoreachethiopianimmigrantsnursemanageddirectlyobservedversusselfadministeredisoniazidtherapy
AT greenmanfred latenttuberculosistreatmentamonghardtoreachethiopianimmigrantsnursemanageddirectlyobservedversusselfadministeredisoniazidtherapy
AT saffouriamer latenttuberculosistreatmentamonghardtoreachethiopianimmigrantsnursemanageddirectlyobservedversusselfadministeredisoniazidtherapy
AT weilerravelldaniel latenttuberculosistreatmentamonghardtoreachethiopianimmigrantsnursemanageddirectlyobservedversusselfadministeredisoniazidtherapy