Completing treatment for latent tuberculosis: patient background matters

BACKGROUND: Treatment of latent infection with Mycobacterium tuberculosis effectively reduces future activation and transmission of tuberculosis. However, patient adherence to preventive treatment influences its effectiveness. Treatment completion is commonly considered as a proxy for adherence. OBJECTIVE: To identify factors associated with failure to complete preventive treatment. DESIGN: Data from 415 consecutive patients who started preventive treatment at the Karolinska University Hospital, Stockholm, Sweden, between 2002 and 2007 were collected and treatment completion was evaluated. Patients were classified as 'completers' or 'non-completers'. Association between treatment completion status and patient characteristics was assessed using logistic regression. RESULTS: Younger patients, patients originating from Somalia and asylum seekers were more likely to be non-completers. The proportion of completers increased from 71% in 2002 to 87% in 2007. However, this trend appears to be caused mostly by an increase in the proportion of European patients. CONCLUSION: The finding of a low rate of treatment completion among Somalis should be regarded as a call for intervention on the individual patient level, also taking into account socio-cultural aspects such as perceptions of health care by the Somali community. Treatment completion continues to be of concern as it is not improving among risk populations.