Awareness and perspectives on expansion of latent TB management among public-sector physicians and medical trainees in Delhi, India.

UNLABELLED: More than one in two healthcare workers (HCWs) in developing countries have latent tuberculosis infection (LTBI), an asymptomatic condition signifying persistent tubercular infection in absence of disease.

OBJECTIVE: to evaluate the physician attitude towards LTBI preventive therapy and their perspectives regarding the potential expansion of latent TB management under the RNTCP.

MATERIAL AND METHODS: We conducted a cross-sectional analysis among 60 participants of a continuing medical education program during October' 2019 in a medical college in Delhi, India.

RESULTS: We enrolled a total of 30 medical officers, 15 resident doctors and 15 medical interns, comprising 27 (45%) males and 33 (55%) females. Only 9 (15%) participants were aware of existing RNTCP guidelines for programmatic management of LTBI. The median (IQR) self-rated willingness of the participants in receiving treatment for LTBI after confirmation of diagnosis on a 10 point continuous rating scale was 6 (5.8). The principal reason attributed to the treatment hesitancy were concerns over drug side effects 19 (31.7%), emergence of drug resistance 11 (18.3%) and the likelihood of reinfection 4 (6.7%). Support for expansion of preventive therapy among household TB contacts was varied, with maximum (41.2%) participants wanting it only for the comorbid patients.

CONCLUSION: LTBI preventive treatment is associated with considerable side effects and lack of long-term benefits by a majority of Indian physicians despite significant personal health concerns in treating pulmonary TB cases.