• Hashem Bishara, Liora Ore, Haya Bshara, Olga Vinitsky, Najat Armaly, and Daniel Weiler-Ravell.
• Tuberculosis Clinic, Nazereth Hospital, Faculty of Medicine, Bar Ilan University, Galilee. hashimbishara@nazhosp.com
• Harefuah. 2014 Jan 1; 153 (1): 8-11, 66.

BackgroundSince the incidence of TB has decreased in the developed countries, the diagnosis and treatment of latent TB infection (LTBI) has assumed increasing importance. It is estimated that 5-10% of persons with LTBI go on to develop TB; therefore, the crucial role of LTBI treatment in eliminating TB is well recognized. However, levels of adherence are found to be consistently low, and noncompliance constitutes the major barrier for achieving the full benefits of LTBI treatment.Objective1. To estimate rates of treatment completion with an outreach - directly observed preventive treatment (DOPT), a program among Ethiopian immigrants (El) at absorption centers treated for LTBI. 2. To determine if follow-up visits by a physician at their place of residence, vs. management at a TB Clinic (TBC), would further enhance the patient's adherence.MethodologyQuasi experiment, retrospective cohort analysis of 495 medical records for all El at absorption centers in Zefat who had started DOPT for LTBI and were followed up at absorption centers (2005-2006, study group - SG), compared to patients followed up at a TBC (2008-2010, comparison group - CG). Free transportation to the TBC was provided for the CG.FindingsAltogether 495 Els were included (263 in the SG and 232 in the CG group). Both groups had high completion rates (SG: 96.2% vs. CG: 93.1%, p=0.14). While demographic factors did not predict treatment completion, side effects were significantly associated with non-completion.ConclusionHigh treatment completion rates among El were achieved when DOPT outreach and cultural case management strategies were combined. In these circumstances, the physician follow-up location had no significant impact on treatment completion rates.

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