Adherence to latent tuberculosis infection therapy among latino immigrants

Background: One third of the world population is infected with Mycobacterium tuberculosis. In the United States, a key component for eliminating tuberculosis (TB) is treating latent TB infection (LTBI) in high-risk persons such as immigrants. Objective: Examine the prevalence of adherence to LTBI therapy and the influence of basic conditioning factors on adherence among Latino immigrants, guided by Orem's Self-Care Deficit Theory. Adherence was treated as a health deviation self-care requisite; the self-care practice of taking daily medication for 9 months is essential to LTBI adherence. Conditioning factors include gender, age, sociocultural factors, environment, and health state. Design: Exploratory, cross-sectional. Sample: Nonprobability sample (n=53) of Latino immigrants attending an urban public health clinic in the Washington, DC metropolitan area. Methods: Participants completed a brief questionnaire documenting selected conditioning factors, and 9-month adherence to LTBI therapy was determined from their medical records. Results: Adherence dropped from 98% in month 2 to 72% at 9 months. The mean number of months adherent was 7.4. Adherence was not significantly associated with gender, country of origin, languages spoken, age, education, or years in the United States. Adherence was slightly lower (t=2.059, p=.059) in persons who knew someone with TB. Conclusions: Nurses should emphasize the importance of adherence for the full 9 months to this population.