2001 International Conference of the American Thoracic Society,
San Francisco, CA. May 2001.
El-Sadr W, Hirsch-Moverman Y,
Colson P, Thomas G, Nader N, Gee V, Findley S, Medard F. Effectiveness
Of Peer Workers In A Treatment Program For Latent TB Infection.
Treatment (tx) for latent tuberculosis infection (LTBI) has
become a high priority in TB control. However, adherence rates
to self-administered LTBI tx have been low. Support from peer
workers in LTBI tx may represent a modality which improves
completion rates, with lower costs than directly observed
In a randomized clinical trial, 231patients (pts) undergoing
treatment for LTBI were assigned to a peer worker (PW) or
self-administered treatment. PWs were members of the same
community, who have successfully completed TB treatment. Most
HIV- pts received 6 mos tx. Definition of on-time tx followed
CDC guidelines (e.g., 6 mo tx within 9 mos for HIV- pts).
Information was collected on pts' social support, service
use, TB knowledge and attitudes, and substance use.
Pts were 56% male, 70% African-American and 22% Latino. Median
age was 34, 47% were foreign-born, 50% completed high school,
and 27% were married. Controls were more likely to have been
homeless (p=.003). Differences in other demographic variables
were not significant. 79% of exp pts completed LTBI tx, compared
to 62% of controls (p=.009). Of those who completed, 89% of
exp pts completed on time, compared to 91% of controls (p=.787).
Of those who were never homeless, 82% of exp pts and 62% of
controls completed (p=.014). Of homeless pts, 71% of exp and
62% of controls completed (p=.470).
This preliminary analysis suggests that PWs can make a vital
contribution to completion of LTBI tx. Homeless pts may need
extra supports to ensure tx completion. Further analyses will
control for the impact of personal characteristics on tx completion.