TY - JOUR
T1 - Successes and challenges of latent TB screening and treatment in a high-prevalence US region
AU - Naqvi, S.
AU - Cantu, Y.
AU - Ong’uti, S.
AU - Cavazos, D.
AU - Johnson, A.
AU - Salazar, C. I.
AU - Morrow, G.
AU - Camden, T.
AU - Santos, N.
AU - Armitige, L.
AU - Ringsdorf, L.
AU - Taylor, B. S.
N1 - Publisher Copyright:
C 2022 The Union.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - B A C K G R O U N D: South Texas has higher TB disease incidence than much of the United States. We evaluated a multi-site South Texas interferon-gamma release assay (IGRA)-based testing and latent TB infection (LTBI) treatment program targeting high-risk populations. M E T H O D S: Number of IGRA tests, test results, LTBI confirmation, and treatment outcomes were collected over 2.5 years. Sixteen semi-structured patient interviews and 10 site-based focus groups were conducted with providers, nurses, and administrators. Grounded theory identified themes associated with successful outcomes. R E S U L T S: Of 9,050 IGRA tests, 687 (8%) were positive; 340 (49%) confirmed as LTBI; 191 initiated LTBI treatment; and 130 (68% of initiators) completed treatment. Patient barriers to treatment completion included lack of knowledge, misconceptions, and treatment toxicities. Clinic staff concurred that toxicity was a barrier to treatment and requiring new processes with limited resources were implementation barriers. C O N C L U S I O N S: Over 9,000 patients were screened with a high prevalence of IGRA positivity, but confirming LTBI, initiating, and completing treatment were challenging. Qualitative evaluation supports low literacy patient education on LTBI and toxicities and expanded support for process implementation and provider training. These findings highlight challenges at all levels of the LTBI care cascade and provide patient, staff, and provider perspectives on implementation of these programs.
AB - B A C K G R O U N D: South Texas has higher TB disease incidence than much of the United States. We evaluated a multi-site South Texas interferon-gamma release assay (IGRA)-based testing and latent TB infection (LTBI) treatment program targeting high-risk populations. M E T H O D S: Number of IGRA tests, test results, LTBI confirmation, and treatment outcomes were collected over 2.5 years. Sixteen semi-structured patient interviews and 10 site-based focus groups were conducted with providers, nurses, and administrators. Grounded theory identified themes associated with successful outcomes. R E S U L T S: Of 9,050 IGRA tests, 687 (8%) were positive; 340 (49%) confirmed as LTBI; 191 initiated LTBI treatment; and 130 (68% of initiators) completed treatment. Patient barriers to treatment completion included lack of knowledge, misconceptions, and treatment toxicities. Clinic staff concurred that toxicity was a barrier to treatment and requiring new processes with limited resources were implementation barriers. C O N C L U S I O N S: Over 9,000 patients were screened with a high prevalence of IGRA positivity, but confirming LTBI, initiating, and completing treatment were challenging. Qualitative evaluation supports low literacy patient education on LTBI and toxicities and expanded support for process implementation and provider training. These findings highlight challenges at all levels of the LTBI care cascade and provide patient, staff, and provider perspectives on implementation of these programs.
KW - IGRA testing
KW - latent tuberculosis infection
KW - program evaluation
KW - qualitative evaluation
UR - http://www.scopus.com/inward/record.url?scp=85135203096&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85135203096&partnerID=8YFLogxK
U2 - 10.5588/ijtld.21.0454
DO - 10.5588/ijtld.21.0454
M3 - Article
C2 - 35898127
AN - SCOPUS:85135203096
SN - 1027-3719
VL - 26
SP - 720
EP - 726
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 8
ER -