Incidence of TB in Inmates with Latent TB Infection5-Year Follow-up

Completion Rate and Side-Effect Profile of Three-Month Isoniazid and Rifapentine Treatment for Latent Tuberculosis Infection in an Urban County Jail

“…Latent TB infection completion rates increased after 3HP implementation compared with 9H. In addition, our 3HP completion rate (85%) was higher than rates in another 9H jail population (32%) and similar to the community 3HP clinical trial (82%) [ 7 , 8 ]. Frequency and severity of ADRs were low in our 3HP cohort.…”

“…Historically, 9H treatment completion rates in correctional settings have been low, between 31% and 37% [ 5 , 6 ]. In addition, patient education and monetary incentives to increase postincarceration LTBI treatment completion have been ineffective [ 7 ].…”

Moving toward Tuberculosis Elimination

“…Suboptimal treatment initiation rates have been attributed to a failure of providers to prescribe LTBI therapy when indicated and to patients' refusal of treatment due to misperceptions of their risk of active TB and potential adverse events (27-29, 44, 45). Regarding LTBI treatment completion, reported rates for 6 to 9 months of isoniazid are typically around 50%; thus, Tennessee's completion rates of 54% is a reasonable achievement for such a large-scale program (27,29,(46)(47)(48)(49)(50)(51)(52). However, had Tennessee met its target initiation and completion rates of 75%, the number of TB cases prevented would have nearly doubled, thereby accelerating the decline in TB incidence and further improving cost-effectiveness.…”

Isoniazid vs. Rifampin for Latent Tuberculosis Infection in Jail Inmates

“…RIF has been suggested as a better alternative because of increasing levels of INH resistance among new immigrants (Reichman, Lardizabal, & Hayden, 2004), an important issue for urban jails with a high proportion of foreign-born inmates. Further work should demonstrate rates of progression to active TB, which was high in jail inmates (White et al, 2005); this study lacks efficacy data. It remains premature to recommend RIF until the relative efficacy and effectiveness compared to INH are known, but it is a suitable alternative, in particular when the patient is likely to be in the facility for the duration of therapy.…”

“…But treatment has not been successful in jails because inmates often are released before completion, and characteristics associated with incarceration are also associated with low rates of follow-up in the community (White et al, 2002). Success in this strategy has been an elusive goal and remains an important public health issue (Glaser & Greifinger, 1993; White et al, 2005). …”