Effects of programmatic interventions to improve the management of latent tuberculosis: a follow up study up to five months after implementation
Effects of programmatic interventions to improve the management of latent tuberculosis: a follow up study up to five months after implementation
Data
2021
Autores
Yanes-Lane, Mercedes
Trajman, Anete
Bastos, Mayara Lisboa
Oxlade, Olivia
Valiquette, Chantal
Rufino, Nathalia
Fregonese, Federica
Menzies, Dick
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Public Health
Resumo
Background: Less than 19% of those needing tuberculosis (TB) preventive treatment complete it, due to losses in
several steps of the cascade of care for latent TB infection. A cluster randomized trial of a programmatic public health
intervention to improve management of latent TB infection in household contacts was conducted in Rio de Janeiro.
Interventions included contact registry, initial and in-service training, and a TB booklet. We conducted a follow-up
study starting one month after the conclusion of this trial, to measure the effect of interventions implemented, and to
identify remaining barriers and facilitators to latent TB infection treatment, from different perspectives.
Methods: In two health clinics in Rio de Janeiro that received the interventions in the trial, data for the latent TB
infection cascade of care for household contacts was collected over a five-month period. The number of household
contacts initiating treatment per 100 index-TB patients was compared with the cascade of care data obtained before
and during the intervention trial. Semi-structured open-ended questionnaires were administered to healthcare workers,
household contacts and index-TB patients regarding knowledge and perceptions about TB and study interventions.
Results: In this follow-up study, 184 household contacts per 100 index-TB patients were identified. When compared to
the intervention period, there were 65 fewer household contacts per 100 index-TB patients, (95% CI -115, − 15) but the
number starting latent TB infection treatment was sustained (difference -2, 95% CI -8,5). A total of 31 index-TB patients,
22 household contacts and 19 health care workers were interviewed. Among index-TB patients, 61% said all their
household contacts had been tested for latent TB infection. All health care workers said it was very important to test
household contacts, and 95% mentioned that possessing correct knowledge on the benefits of latent TB infection
treatment was the main facilitator to enable them to recommend this treatment.
Conclusion: In this follow-up study, we observed a sustained effect of interventions to strengthen the latent TB
infection cascade of care on increasing the number of household contacts starting latent TB infection treatment.
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Citação
Yanes-Lane M, Trajman A, Bastos ML, Oxlade O, Valiquette C, Rufino N, Fregonese F, Menzies D. Effects of programmatic interventions to improve the management of latent tuberculosis: a follow up study up to five months after implementation. BMC Public Health. 2021 Jan 21;21(1):177. doi: 10.1186/s12889-021-10195-z.