2001 International Conference of the American Thoracic Society,
San Francisco, CA. May 2001.
Hirsch-Moverman Y, O'Garro-Humphrey
P, Medard F, Nader N, Thomas G, El-Sadr W. Adherence
And Tuberculosis Knowledge Among Patients In A Directly Observed
Preventive Therapy Program In Harlem.
An important strategy in TB control is ensuring completion
of treatment of latent TB infection (LTBI), especially among
high-risk patients. Directly Observed Preventive Therapy (DOPT)
has been used successfully in special populations. Little
is known about TB knowledge among patients (pts) beginning
DOPT, and the impact of these parameters on adherence (ADH)
We assessed pts demographics, substance use, TB knowledge,
and treatment ADH in Harlem "surrogate family" clinic-based
DOPT program. The knowledge portion included 24 items on transmission,
testing and treatment.
Of 67 patients, 76% were African-American, 15% Latino, 45%
foreign-born, mean age of 44 years, 38% had a history of homelessness,
42% had completed high school, 68% had a history of substance
use, 27% were currently using illicit drugs and 10% were previously
treated for LTBI. At baseline, 67% of patients had known HIV
status with 23% HIV positive. Overall, treatment ADH with
doses was 96%, with 77% of patients taking >95% of prescribed
medications. Of twenty-four questions regarding TB knowledge,
15.2% of patients with ADH>95% and 16.7% of patients with
adherence <95% answered correctly 75% or more of questions
with mean score of 15.7. Patients had similar TB knowledge
scores regardless of ADH or HIV status.
Pts enrolled in the Harlem DOPT Program had exceptionally
high treatment adherence in spite of characteristics thought
to be associated with non ADH. TB knowledge at baseline was
not associated with ADH.