Knowledge of Tuberculosis Among Drug Users

Salomon, Nadim; Perlman, David C.; Friedmann, Patricia; Perkins, Mary Patricia; Ziluck, V.; Jarlais, Don C. Des; Paone, Denise

doi:10.1016/s0740-5472(98)00033-6

Cited by 21 publications

(8 citation statements)

References 17 publications

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“…[28] The average treatment IPT duration was not significantly higher in the DOT group (p<0.216), and the total 9-month IPT completion of the DOT group did not statistically differ from the SAT group (p=0.155).…”

Section: Discussionmentioning

confidence: 99%

Latent Tuberculosis Infection: Screening and Treatment in an Urban Setting

et al. 2013

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Background Despite its benefit for treating active tuberculosis, directly observed therapy (DOT) for latent tuberculosis infection (LTBI) has been largely understudied among challenging inner city populations. Methods Utilizing questionnaire data from a comprehensive mobile healthcare clinic in New Haven, CT from 2003 to July 2011, a total of 2523 completed tuberculin skin tests (TST’s) resulted in 357 new LTBIs. Multivariate logistic regression correlated covariates of the two outcomes 1) initiation of isoniazid preventative therapy (IPT) and 2) completion of 9-months IPT. Results Of 357 new LTBIs, 86.3% (n=308) completed screening CXRs: 90.3% (n=278) were normal and 0.3% (n=1) with active tuberculosis. Of those completing CXR screening, 44.0% (n=135) agreed to IPT: 69.6% (n=94) selected DOT, and 30.4% (n=41) selected SAT. Initiating IPT was correlated with undocumented status (AOR=3.43; p<0.001) and being born in a country of highest and third highest tuberculosis prevalence (AOR=14.09; p=0.017 and AOR=2.25; p=0.005, respectively). Those selecting DOT were more likely to be Hispanic (83.0% vs 53.7%; p<0.0001), undocumented (57.4% vs 41.5%; p=0.012), have stable housing (p=0.002), employed (p<0.0001), uninsured (p=0.014), no prior cocaine or crack use (p=0.013) and no recent incarceration (p=0.001). Completing 9-months of IPT was correlated with no recent incarceration (AOR 5.95; p=0.036) and younger age (AOR 1.03; p=0.031). SAT and DOT participants did not significantly differ for IPT duration (6.54 vs 5.68 months; p=0.216) nor 9-month completion (59.8% vs 46.3%; p=0.155). Conclusions In an urban mobile healthcare sample, screening completion for LTBI was high with nearly half initiating IPT. Undocumented, Hispanic immigrants from high prevalence tuberculosis countries were more likely to self-select DOT at the mobile outreach clinic, potentially because of more culturally, linguistically, and logistically accessible services and self-selection optimization phenomena (SSOP). Within a diverse, urban environment, DOT and SAT IPT models for LTBI treatment resulted in similar outcomes, yet outcomes were hampered by differential measurement bias between DOT and SAT participants.

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Section: Discussionmentioning

confidence: 99%

Latent Tuberculosis Infection: Screening and Treatment in an Urban Setting

et al. 2013

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“…TB knowledge and perceptions may further impact care-seeking behavior[101]. In knowledge surveys, most IDUs understood they were at high risk for TB[102], that HIV infection increases TB risk[103], and that TB is treatable[101, 103].…”

Section: Barriers To Care and Treatment Adherencementioning

confidence: 99%

“…In knowledge surveys, most IDUs understood they were at high risk for TB[102], that HIV infection increases TB risk[103], and that TB is treatable[101, 103]. However, fewer drug users were aware that TB is spread by coughing[20, 102] or that people could become resistant to medication[102]; confusion between infection and disease is also common[20].…”

Section: Barriers To Care and Treatment Adherencementioning

confidence: 99%

Tuberculosis and Illicit Drug Use: Review and Update

2009

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Illicit drug users continue to be a group at high risk for tuberculosis (TB) infection and disease. In this article, we present an updated review on the relationship between TB and drug use, summarizing more than a decade of new research. Drug users, and injection drug users in particular, have driven TB epidemics in a number of countries. The successful identification and treatment of TB among drug users remains an important component of a comprehensive TB strategy, but drug users present a unique set of challenges for TB diagnosis and control. New diagnostic modalities, including interferon-γ release assays (IGRAs), offer potential for improved diagnosis and surveillance among this group, alongside proven treatment strategies which incorporate the use of directly-observed therapy (DOT) with treatment for drug abuse. Special considerations, including co-infection with viral hepatitis and the Rifampin/methadone drug interaction, warrant clinical attention and are also updated here.

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“…More importantly, knowledge of STIs has not been well studied in drug users but it may be inadequate based on low knowledge regarding hepatitis, tuberculosis and HIV among drug users nationally and in NYC (Salomon, Perlman, Friedmann et al, 1999; McCoy et al, 2005; Hagan et al, 2006, Feist-Price, Logan, Leukefeld, Moore & Ebreo; 2003). Van de Hoek (1997) found that drug users are unaware that STIs increase the risk of HIV infection and generally do not seek STI testing unless symptoms are relatively severe.…”

Section: Introductionmentioning

confidence: 99%