Skip to main content

Advertisement

Table 1 Overview of determinants of LTBI treatment initiation, adherence and completion in the general population diagnosed with LTBI

From: Interventions for improving adherence to treatment for latent tuberculosis infection: a systematic review

Determinant Specification determinant (vs. reference group) Number of articles
Positive association Inverse association
P R P R
Determinants of LTBI treatment initiation
 Age Older age (vs. younger age) 1 [49] 2 [22, 26]
 Gender Men (vs. women) 1 [26] 1 [49]
 Sub-population within general population with LTBI Refugee/immigrants (vs. born in country of study) 1 [25] 1 [26]
Immigrants born in WHO category 3 or 5 country (vs. category 1 country)A 1 [25]
HCW (vs. no HCW) 2 [22, 23]
Case contact (vs. no case contact) 1 [24] 2 [22, 23]
 Education Lower education level (vs. n.r.) 1 [24]
 Behaviour Alcohol use reported at baseline (vs. no alcohol use reported) 1 [49]
 Other Continuity of primary care by consulting a regular physician (vs. n.r.) 1 [24]
Pregnant (vs. not pregnant) 1 [47]
Prior incarceration (vs. n.r.) 1 [24]
Fear of getting sick with TB without medicine (vs. no fear of getting sick) 1 [24]
Previous BCG vaccination (vs. n.r.) 1 [22]
Abnormal CXR findings consistent with previous TB (vs. n.r.) 1 [22]
A non-employment reason for screening (vs. n.r.) 1 [24]
Determinants of LTBI treatment adherence
 Age Older age (vs. younger age) 1 [75]
 Ethnicity BiculturalD (vs. Hispanic or non-Hispanic) 1 [75]  
 Education Higher grades in school (vs. lower grades) 1 [75]
 Behaviour Risk behaviours (vs. n.r.)E 2 [75, 76]
 Adverse events Some somatic complaints (vs. n.r.) 1 [76]
Determinants of LTBI treatment completion
 Age Older (vs. younger) 3 [43, 58]B, C 4 [29, 31, 42, 44]G 3 [25, 77, 78] 6 [23, 28, 30, 41, 46, 79]
 Gender Male (vs. female) 2 [30, 44]
 Ethnicity Hispanic/Latino ethnicity (vs. Asian ethnicity) 1 [78]  
White Hispanic (vs. black, non-Hispanic) 1 [30, 34, 46]
Country of birth (i.e. Haiti, Dominican Republic, China with HK or Vietnam) (vs. other countries) Varying results found between countries [80]    
Asian/Pacific Islander (vs. white) 2 [42, 44]
Region of origin (i.e. Latin America and Caribbean or Asia and other) (vs. USA, Canada, Europe) 1 [41]
Black race (vs. n.r.) 1 [29]G
Ethnicity (i.e. Asian, Non-Hispanic black or Hispanic (vs. non-Hispanic white)   1 [31]   
 Sub-population within source population HCW (vs. no HCW) 1 [23]
Case contact (vs. no case contact) 1 [31] 1 [29]F
Currently homeless (vs. not currently homeless) 2 [30, 32]
PWID (vs. no PWID) 2 [23, 34]
Refugees/immigrants (vs. born in country of study) 1 [27] 4 [2831]G   2 [32] [33]
Indication for LTBI treatment immunosuppression (vs. case contact) 1 [43]C
 Health History of hepatitis A, B or C (vs. no history of liver disease) 1 [77]
Other medications reported at baseline (vs. none reported) 1 [29]F
Use of concomitant medications by women (vs. no use of concomitant medication) 1 [49]
 Behaviour (Excess) alcohol use (vs. no alcohol use) 4 [29, 30, 32, 49]F
Smoking (vs. non-smoking) 1 [43]C
 Treatment Treatment without H (vs. treatment with H) 1 [43]C 5 [31, 3942]
9-months H (vs. other regimens) 1 [23]
Regimen choice offered (vs. no regimen choice offered) 1 [79]
Twice weekly RZ (vs. daily RZ) 1 [81]
DOT (vs. SAT) 3 [31, 44, 45]
 Adverse events Adverse events (vs. no adverse events) 7 [30, 33, 41, 4649]
Adverse events (i.e. grade 1 or 2 hepatotoxicity, grade 3 or 4 hepatotoxicity or adverse events other than hepatotoxicity) (vs. n.r.) Conflicting results found between adverse events [51]    
 Other Not having been incarcerated within 6 months of diagnosis (vs. n.r.) 1 [25]
Referral reason (i.e. correctional/rehabilitation or postpartum women) (vs. TST positive from screening) 1 [28]
Risk group (i.e. contact, medical riskH, population riskI) (vs. low riskJ) 1 [31]
Cause of screening/referral (i.e. asylum seekers or contacts) (vs. anti-TNF-α candidates) 1 [82]
Fear for venepuncture (vs. n.r.) 1 [83]
Low TB risk perception (vs. n.r.) 1 [83]
Plan to tell friends or family about LTBI diagnosis (vs. n.r.) 1 [24]
Home situation (i.e. child living with no or one natural parent) (vs. living with both natural parents) 1 [27]
Spanish language (vs. non-Spanish language) 1 [60]
Resident in a congregate setting (vs. never or unknown) 1 [23]
Missed appointment call or letter (vs. no missed appointment call) 1 [60]
No medical insurance (vs. medical insurance) 1 [47]
Clinic attendance before treatment (vs. clinic non-attendance before treatment) 1 [79]
Presumed non-recent TB infection (vs. presumed recent TB infection) 1 [34]
Public health nurse referral (vs. no public health nurse referral) 1 [60]
  1. BCG Bacillus Calmette-Guérin; CXR chest radiograph; DOT directly observed therapy; H isoniazid; HCW healthcare worker; HK Hong Kong; i.e. id est; LTBI latent tuberculosis infection; n.r. not reported; PWID people who inject drug; RZ rifampicin and pyrazinamide; SAT self-administered therapy; TB tuberculosis; TNF tumor necrosis factor; TST tuberculin skin test; USA United States of America; WHO World Health Organisation
  2. AWHO defined 5 categories of TB prevalence based on 1st (least prevalent) to 5th (most prevalent). BData analysed in individuals that underwent three QFT-GIT. CData analysed in individuals who underwent at least one serial QFT-GIT. DBicultural is defined by questions separated into the domains Hispanic and non-Hispanic, considering language use, linguistic proficiency and electronic media use. Individuals scoring high in both domains are considered bicultural. ERisk behaviours: ever used alcohol, cigarettes, marijuana, been expelled or suspended from school, or been in a physical fight. FData analysed in Hispanic subjects for one study. GData analysed in non-Hispanic subjects for one study HPersons with medical risk factors such as having a TST conversion within two years of a negative TST, HIV infection, untreated or partially treated prior TB, suspected TB with an abnormal chest radiograph, being younger than five years of age with a positive TST, or having a clinical condition associated with an increased risk of TB disease. Ipersons with population risk factors such as: recent immigrants to the USA (5 years) from countries with high TB prevalence, homeless persons, residents and employees of congregate settings such as prisons and jails, and healthcare facilities. Jpersons with low risk for developing TB disease (no case contact, no medical risk, no population risk factors)