International Journal of Tuberculosis and Lung Disease
Volume 19, Issue 7, 2015, Pages 799-804

Cost of nurse-managed latent tuberculous infection treatment among hard-to-reach immigrants in Israel (Article)

Bishara H.* , Ore L. , Vinitsky O. , Bshara H. , Armaly N. , Weiler-Ravell D.
  • a Pulmonary Division and Tuberculosis Centre, Nazareth Tuberculosis Clinic, Nazareth Hospital, PO Box 422, Nazareth, 16100, Israel, Faculty of Medicine in Galilee, Bar Ilan University, Ramat Gan, Israel, Faculty of Social Welfare and Health Science, School of Public Health, University of Haifa, Haifa, Israel
  • b Faculty of Social Welfare and Health Science, School of Public Health, University of Haifa, Haifa, Israel, Department of Health Systems Management, Yezreel Valley College, Yezreel Valley, Israel
  • c Public Health Department, Ministry of Health, Northern District, Nazareth, Israel
  • d Pulmonary Division and Tuberculosis Centre, Nazareth Tuberculosis Clinic, Nazareth Hospital, PO Box 422, Nazareth, 16100, Israel
  • e Pulmonary Division and Tuberculosis Centre, Nazareth Tuberculosis Clinic, Nazareth Hospital, PO Box 422, Nazareth, 16100, Israel
  • f Pulmonary Division and Tuberculosis Centre, Nazareth Tuberculosis Clinic, Nazareth Hospital, PO Box 422, Nazareth, 16100, Israel

Abstract

BACKGROUND: Adherence to treatment of latent tuberculous infection (LTBI), an essential component of tuberculosis (TB) elimination, is generally unsatisfactory. OBJECTIVES : To examine the adherence and costs of nurse-managed, semi-directly observed preventive treatment (semi-DOPT) with twice-weekly isoniazid among hard-to-reach Ethiopian immigrants, and to compare the treatment outcomes of onsite vs. regional TB clinicbased physician's follow-up. METHODS: This was a quasi-experimental retrospective cohort analysis of LTBI treatment among Ethiopian immigrants in reception centres in the Zefat subdistrict of Northern Israel, screened and treated for LTBI during 2005-2011. Two physician follow-up appointments were scheduled for each patient. RESULTS : Of 663 eligible Ethiopian immigrants included in the study, 628 (94.7%) completed treatment. Treatment outcomes were similar among onsite vs. regional TB clinic-based physician follow-up. Noncompletion was significantly associated with side effects (P ≤ 0.001). The total costs of treatment were relatively low, but were significantly higher for the TB clinic-based physician follow-up group. CONCLUSION: Nurse-managed semi-DOPT for LTBI treatment with reduced physician follow-up among hard-to-reach Ethiopian immigrants was efficient and safe. Providing on-site physician follow-up proved to be cheaper than standard follow-up at the regional TB clinic. Starting LTBI treatment at an early stage after immigration, and providing treatment and convenient transportation free of charge probably also contributed to the high treatment completion rates. © 2015 The Union.

Author Keywords

Ethiopian Directly observed Congregate settings LTBI Outreach reception centres

Index Keywords

immigrant Israel economics follow up human middle aged Ethiopian statistics and numerical data controlled study priority journal comparative study nursing care Humans semi directly observed preventive treatment Young Adult health care cost patient safety liver toxicity migrant treatment duration Treatment Outcome Antitubercular Agents tuberculostatic agent Adolescent latent tuberculosis preschool child male Emigrants and Immigrants Child, Preschool female communicable disease control Ambulatory Care Facilities outpatient department Article gastrointestinal symptom Retrospective Studies Ethiopia patient compliance drug withdrawal adult major clinical study isoniazid age cohort analysis Directly Observed Therapy retrospective study clinical effectiveness Time-to-Treatment time to treatment Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84930813152&doi=10.5588%2fijtld.14.0674&partnerID=40&md5=93ca39d8d2ccbc2c2a29e15b4edea2ff
DOI: 10.5588/ijtld.14.0674
ISSN: 10273719
Original Language: English