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Evaluation and treatment of latent tuberculosis infection among healthcare workers in Korea: A multicentre cohort analysis.

ABSTRACT: OBJECTIVE:Healthcare workers (HCWs) are one of the target groups for systematic testing and treatment of latent tuberculosis infection (LTBI) in a setting of low TB incidence. We performed this study to describe the testing of HCWs for LTBI and analyse the acceptance and completion of treatment of LTBI. METHODS:This retrospective cohort study was conducted in four university-affiliated hospitals between January 1 and December 31, 2018. HCWs with positive interferon-gamma release assay (IGRA) during LTBI screening were analysed. We assessed the acceptance and completion of LTBI treatment. RESULTS:Overall, 893 HCWs were IGRA positive. Among them, 609 HCWs visited the clinic for evaluation of LTBI. Of 609 HCWs who were evaluated, 302 (49.6%) were offered treatment for LTBI. The proportion of acceptance for treatment was 64.5% (195 of 302 HCWs). The treatment course was completed by 143 of 195 HCWs (73.3%). Three months of isoniazid and rifampin (3HR) was used in 137 HCWs (70.3%) and 4 months of rifampin (4R) in 58 (29.7%). 72 HCWs (36.9%) experienced at least one adverse drug events, but there was no different characteristics between completer and non-completer. CONCLUSION:The acceptance and completion of LTBI treatment were unsatisfactory. Subjective perspective regarding obstacles to treatment of LTBI needs to be explored to increase compliance to LTBI treatment.

SUBMITTER: Han SS

PROVIDER: S-EPMC6752845 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Evaluation and treatment of latent tuberculosis infection among healthcare workers in Korea: A multicentre cohort analysis.

Han Seon-Sook SS Lee Su Jin SJ Yim Jae-Joon JJ Song Jin Hwa JH Lee Eun Hye EH Kang Young Ae YA

PloS one 20190919 9

<h4>Objective</h4>Healthcare workers (HCWs) are one of the target groups for systematic testing and treatment of latent tuberculosis infection (LTBI) in a setting of low TB incidence. We performed this study to describe the testing of HCWs for LTBI and analyse the acceptance and completion of treatment of LTBI.<h4>Methods</h4>This retrospective cohort study was conducted in four university-affiliated hospitals between January 1 and December 31, 2018. HCWs with positive interferon-gamma release a ...[more]

PMID: 31536577

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Project description:BACKGROUND:Successful treatment of latent tuberculosis infection (LTBI) is essential to reduce tuberculosis (TB) incidence rates in low-burden countries. This study measures treatment completion and determinants of non-completion of LTBI treatment in Norway in 2016. METHODS:This prospective cohort study included all individuals notified with LTBI treatment to the Norwegian Surveillance System for Infectious Diseases (MSIS) in 2016. We obtained data from MSIS and from a standardized form that was sent to health care providers at the time of patient notification to MSIS. We determined completion rates. Pearson's chi squared test was used to study associations between pairs of categorical variables and separate crude and multivariable logistic regression models were used to identify factors associated with treatment completion and adverse drug effects. RESULTS:We obtained information on treatment completion from 719 of the 726 individuals notified for LTBI treatment in 2016. Overall, 91% completed treatment. Treatment completion was highest in the foreign-born group [foreign-born, n =?562 (92%) vs Norwegian-born, n =?115 (85%), p =?0.007]. Treatment completion did not differ significantly between prescribed regimens (p =?0.124). Adverse events were the most common reason for incomplete treatment. We found no significant differences in adverse events when comparing weekly rifapentine (3RPH) with three months daily isoniazid and rifampicin (3RH). However, there were significantly fewer adverse events with 3RPH compared to other regimens (p =?0.037). Age over 35 years was significantly associated with adverse events irrespective of regimen (p =?0.024), whereas immunosuppression was not significantly associated with adverse events after adjusting for other variables (p =?0.306). Treatment under direct observation had a significant effect on treatment completion for foreign-born (multivariate Wald p-value?=?0.017), but not for Norwegian-born (multivariate Wald p-value?=?0.408) individuals. CONCLUSIONS:We report a very high treatment completion rate, especially among individuals from countries with high TB incidence. The follow-up from tuberculosis-coordinators and the frequent use of directly observed treatment probably contributes to this. Few severe adverse events were reported, even with increased age and in individuals that are more susceptible. While these results are promising, issues of cost-effectiveness and targeting treatment to individuals at highest risk of TB are important components of public health impact.

Dataset Information

Evaluation and treatment of latent tuberculosis infection among healthcare workers in Korea: A multicentre cohort analysis.

Publications

Evaluation and treatment of latent tuberculosis infection among healthcare workers in Korea: A multicentre cohort analysis.

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