2001 International Conference of the American Thoracic Society, San Francisco, CA. May 2001.

Uwaoma UE, Gwynn RC, Medard F, Berthaud V, El-Sadr W. Socio-Clinical Factors Associated With Treatment Completion Among TB Patients In The Harlem DOT Program, 1993-1998.

Objective: To assess the social and clinical characteristics in tuberculosis (TB) patients in a Directly Observed Therapy (DOT) Program and determine those factors associated with treatment completion.

Method: A retrospective analysis of culture confirmed TB cases enrolled in the DOT program at Harlem Hospital between 1993 and 1998 was conducted. Variables included patient's age, race/ethnicity, sex, country of origin, HIV status, drug and alcohol use, housing, and drug susceptibility results. The chi-squared test was used to compare treatment completion rates for categorical data and the t-test was used to compare means of continuous data.

Results: Among the 273 patients with confirmed TB treated at DOT, 83% were African American, 13% were Latino and 23% were foreign-born. Recent incarceration was reported by 11% of the patients, while 19% reported intravenous drug use, 38% reported alcohol use, and 11% reported homelessness. Multiple-drug resistant TB was reported in 7% of the patients and 41% reported testing positive for HIV. Of the above factors considered, patients who tested positive for HIV were less likely to complete treatment (p<0.05), while the foreign-born and those with multiple drug resistant TB were more likely to complete treatment (p<0.05)

Conclusion: Ensuring treatment completion for active TB is especially important in Harlem where socio-economic problems, such as drug use and HIV infection are very prevalent. These results suggest that the DOT program in Harlem and those similar communities should continue to focus their effort on this disenfranchised population.