Getting to Zero: Tuberculosis Elimination in California

Barry, Pennan M.; Kay, Alexander; Flood, Jennifer; Watt, James

doi:10.1007/s40471-016-0076-6

Cited by 9 publications

(7 citation statements)

References 17 publications

(20 reference statements)

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“…In California, only about 20% of persons with LTBI know that they are infected and only about 12% have been treated. 2,3 In contrast, because LTBI screening is required in the California prison system, all CCHCS patients with LTBI know that they are infected, and all patients with untreated LTBI are encouraged to start treatment every year during the required annual tuberculosis screening that occurs during their birth month. Because the average incarceration length in California is 36 months and almost all patients are in prison for at least 6 months, most patients are able to complete the 3HP regimen during their incarceration.…”

Section: Discussionmentioning

confidence: 99%

Completion Rates, Adverse Effects, and Costs of a 3-Month and 9-Month Treatment Regimen for Latent Tuberculosis Infection in California Inmates, 2011-2014

Wheeler¹,

Mohle-Boetani²

2019

Public Health Rep

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Objectives: In California, about 80% of tuberculosis disease is caused by untreated latent tuberculosis infection (LTBI), and the rate of LTBI is higher among incarcerated persons (16%) than among nonincarcerated persons (6%). We compared 2 regimens to treat LTBI in an adult prison population in California: 9 months of twice-weekly isoniazid (9H; previous standard of care) and 12 once-weekly doses of isoniazid and rifapentine (3HP; introduced in 2011). Methods: We evaluated the rates of completion and discontinuation caused by hepatotoxicity among randomly selected patients with LTBI prescribed the 9H regimen in 2011 and among patients with LTBI prescribed the 3HP regimen who entered California prisons during September 2013-March 2014. We compared the cost per fully treated patient for the 2 regimens. Results: Of 92 patients treated with the 9H regimen, the treatment completion rate was 42% and discontinuation due to hepatotoxicity was 14%. Of 122 patients who accepted the 3HP regimen, the completion rate was 90% and discontinuation due to hepatotoxicity was 2%. The cost per fully treated patient for the 9H regimen was $981 and for 3HP was $652. Conclusions: In an incarcerated population, the 3HP regimen had a higher completion rate, lower hepatotoxicity, and lower cost per fully treated patient than the 9H regimen. If coupled with a high treatment initiation rate, the high rate of LTBI treatment completion with 3HP may contribute to reducing tuberculosis morbidity in California.

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Section: Discussionmentioning

confidence: 99%

Completion Rates, Adverse Effects, and Costs of a 3-Month and 9-Month Treatment Regimen for Latent Tuberculosis Infection in California Inmates, 2011-2014

Wheeler¹,

Mohle-Boetani²

2019

Public Health Rep

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“…This approach may theoretically help progress toward TB elimination in some higher-income settings in which a high proportion of TB cases arise from reactivation among foreign-born migrants with DM, suggesting that this group may be an appropriate population on which to focus LTBI screening. 59,62 LTBI diagnosis is very important and should precede treatment. However, the few studies in the literature on the impact of DM on TB are small and show contradictory results regarding the QuantiFERON test (Qiagen) in patients with DM.…”

Section: Screening Patients With Dm For Ltbimentioning

confidence: 99%

Defining a Research Agenda to Address the Converging Epidemics of Tuberculosis and Diabetes

Critchley

Restrepo

Ronacher

et al. 2017

Chest

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There is growing interest in the interaction between type 2 diabetes mellitus (DM) and TB, but many research questions remain unanswered. Epidemiologists, basic scientists, and clinical experts recently convened and identified priorities. This is the first of two reviews on this topic, summarizing priority areas of research regarding epidemiology, clinical management, and public health. First, from an epidemiologic point of view, more study is needed to determine the importance of transient hyperglycemia in patients with TB and on the importance of DM for the global epidemic of multidrug resistant (MDR)-TB. Second, regarding the screening and clinical management of combined TB and DM (TB-DM), clinical trials and large cohort studies should examine the benefits of improved DM care as well as prolonged or intensified TB treatment on the outcome of TB-DM and investigate the cost-effectiveness of screening methods for DM among patients newly diagnosed with TB. Third, from a public health and health systems point of view, the population health impact and cost-effectiveness of different interventions to prevent or treat DM and TB in high-burden populations should be examined, and health-system interventions should be developed for routine TB-DM screening, management of DM after completion of TB treatment, and better access to DM services worldwide. Studies are needed across different ethnicities and settings given the heterogeneity of metabolic perturbations, inflammatory responses, medications, and access to health care. Finally, studies should address interactions between TB, DM, and HIV because of the convergence of epidemics in sub-Saharan Africa and some other parts of the world.

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“…In 2014, an estimated 2.4 million Californians had LTBI, with the most cases among foreign‐born Asians (Barry et al, 2016). This group of immigrants has carried the heaviest burden of TB disease in California for more than a decade (Tuberculosis Control Branch, 2019).…”

Section: Introductionmentioning

confidence: 99%

Non‐completion of latent tuberculosis infection treatment among Vietnamese immigrants in Southern California: A retrospective study

Truax

Morisky

Low

et al. 2020

Public Health Nursing

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Objectives: To examine socio-demographic and health-related factors associated with latent tuberculosis infection (LTBI) treatment refusal, non-initiation, and noncompletion among a cohort of Vietnamese immigrants. Design: This is a retrospective cohort study in which LTBI charts were reviewed at a public health clinic in Orange County, California between January 2010 and August 2011. Sample: Altogether, 474 patient charts with documented LTBI treatment were reviewed for patients who met the inclusion criteria. Measurements: Univariate and multivariate analyses were used to identify sociodemographic and health-related factors associated with LTBI treatment refusal, noninitiation, and non-completion. Results: Of the 474 charts reviewed, 171(36.1%) patients refused LTBI treatment and 21(6.9%) accepted but did not initiate. Of the 282 that started treatment, 62 (22.0%) did not complete the regimen prescribed. The primary barrier documented for treatment refusal and non-completion was concern about medication side effects. Other barriers to treatment non-completion include transportation issues and conflicts with travel plans or work schedules. Conclusions: Community and public health nurses working with the Vietnamese immigrant population can play a vital role in improving patients' LTBI treatment acceptance, initiation, and completion. A proactive approach to addressing barriers and potential medication side effects can improve overall treatment success.

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Getting to Zero: Tuberculosis Elimination in California

Cited by 9 publications

References 17 publications

Completion Rates, Adverse Effects, and Costs of a 3-Month and 9-Month Treatment Regimen for Latent Tuberculosis Infection in California Inmates, 2011-2014

Completion Rates, Adverse Effects, and Costs of a 3-Month and 9-Month Treatment Regimen for Latent Tuberculosis Infection in California Inmates, 2011-2014

Defining a Research Agenda to Address the Converging Epidemics of Tuberculosis and Diabetes

Non‐completion of latent tuberculosis infection treatment among Vietnamese immigrants in Southern California: A retrospective study

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