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Successful Treatment of Pediatric Latent Tuberculosis Infection in a Community Health Center Clinic.
MedLine Citation:
PMID:  22531235     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: This study evaluates completion of treatment for latent tuberculosis infection (LTBI) in Mexican immigrant children aged 1-18 years in a Community Health Center (CHC). METHODS: Children were screened for LTBI at the CHC. All children with a tuberculin skin test (TST) >= 10 mm had a chest radiograph (CXR). Those with negative CXR had nurse appointments to collect demographic information and to begin 9 months of INH treatment. A minimum 6 months of INH treatment defined completion. RESULTS: Between 11/15/2006 and 3/15/2009, 157 children had positive TSTs. Three never had a CXR, 2 had misdiagnosed LTBI and 2 had asymptomatic active tuberculosis. Of 150 with LTBI, 111 (74%) completed INH at CHC. Thirteen (9%) transferred care to school-based clinics (SBC) or TB clinic (TBC), and 4 (3%) never started treatment. Twenty-two (15%) did not complete treatment at CHC. One developed INH hepatitis and 21 were lost to follow-up. Of 13 who transferred to SBC/TBC, 10 completed therapy, with 121 (81%) completing treatment started at CHC. By logistic regression factors associated with not starting/incomplete LTBI treatment were older age, increased number of days between TST and CXR, and 0-1 well care visits versus >= 2 visits before TST placement. A visit copay >= $15.00 was associated with transfer of care to SBC/TBC. CONCLUSION: Pediatric LTBI can be successfully treated by CHC nurses. Completion of treatment was associated with younger age, fewer days between TST reading and CXR, and being an established patient in the CHC.
Authors:
Janine Young; Mary Ellen O'Connor; Tara Edick; Debbie Klee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-23
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  -     ISSN:  1532-0987     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Yale University School of Medicine, Department of Pediatrics, Medical Director, Pediatric Primary Care Clinic, Hospital of Saint Raphael 2 University of Colorado School of Medicine, Denver Health and Hospitals 3 Denver Health and Hospitals.
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