Supervised Preventive Therapy for Latent Tuberculosis Infection in Illegal Immigrants in Italy

Abstract

In a multicenter, prospective, randomized, open-label study of isoniazid-preventive therapy (IPT) for latent tuberculosis infection, illegal immigrants from countries where tuberculosis is highly endemic were enrolled at two clinical sites in Northern Italy. Of 208 eligible subjects, 82 received supervised IPT at a dose of 900 mg twice weekly for 6 mo (Regimen A), 73 received unsupervised IPT 900 mg twice weekly for 6 mo (Regimen B), and 53 received unsupervised IPT 300 mg daily for 6 mo (Regimen C). Supervised IPT was delivered at either one tuberculosis clinic or one migrant clinic. The probability of completing a 26-wk regimen was 7, 26, and 41% in Regimens A, B, and C, respectively (p < 0.005, Log- rank test calculated using Kaplan-Meier plots). The mean time to dropout was 3. 8, 6, and 6.2 wk in Regimens A, B, and C, respectively (p = 0.003 for regimen A versus either Regimens B or C). Treatment was stopped in five subjects (2.4%) because of adverse events. The rate of completion of preventive therapy for latent tuberculosis infection among illegal immigrants was low. Supervised, clinic-based administration of IPT significantly reduced adherence. Alternative strategies to implement preventive therapy in illegal immigrants are clearly required.

Screening for latent tuberculosis infection among undocumented immigrants in Swiss healthcare centres; a descriptive exploratory study

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QuantiFERON®-TB Gold test in the identification of latent tuberculosis infection in immigrants

“…16 In addition, the identification and 17,18 Based on these premises we were interested in evaluating new approaches for the identification of LTBI among immigrants that could be associated with a better performance when compared to TST. Our results showed that the percentage of concordant results between TST and QuantiFERON â -TB Gold test was low (71%), with a k coefficient indicative of poor agreement (0.37).…”

Meta-analysis of factors related to health services that predict treatment default by tuberculosis patients

“…The standard TB treatment regimen is effective but is not applied efficiently in most countries. Worldwide, TB treatment default has been estimated at between 1% and 20% 1 , but the rate is as high as 60%, 70%, and even 80% in selected populations 3,4,5,6,7 .…”