Effect of directly observed preventive therapy for latent tuberculosis infection in San Francisco.

SETTING

San Francisco TB Clinic instituted a directly observed preventive therapy (DOPT) program for treatment of persons with latent TB infection in 1996.

OBJECTIVE

To examine therapy completion for latent tuberculosis infection before and after implementation of the DOPT program.

DESIGN

Medical records were analyzed for patients at the San Francisco TB Clinic referred from high-risk sites for the periods 1993-1994 (n = 619) and 1997-June 1998 (n = 460). Treatment completion and time of therapy were analyzed comparing DOPT to self-administered therapy (SAT).

RESULTS

More DOPT patients completed treatment (70.3%) than SAT patients (47.9%) (P < 0.001). Controlling for sex, age, race/ethnic group and cohort, patients on DOPT were nearly twice as likely to complete therapy (OR 1.93, 95% CI 1.25-3.00).

CONCLUSION

DOPT is a successful strategy. Combined with targeted testing, DOPT can have an important impact in areas with traditionally low rates of treatment adherence.