lunes, 17 de abril de 2017

Use of Video Directly Observed Therapy for Treatment of Latent Tuberculosis Infection — Johnson County, Kansas, 2015 | MMWR

Use of Video Directly Observed Therapy for Treatment of Latent Tuberculosis Infection — Johnson County, Kansas, 2015 | MMWR
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MMWR Weekly
Vol. 66, No. 14
April 14, 2017


Use of Video Directly Observed Therapy for Treatment of Latent Tuberculosis Infection — Johnson County, Kansas, 2015


Elizabeth Lawlor Holzschuh, MS1; Stacie Province, MSN1; Krystle Johnson, MSN1; Caitlin Walls, MPH1; Cathy Shemwell1; Gary Martin, MPA1; Amy Showalter1; Jennifer Dunlay1; Andrew Conyers, MPA1; Phil Griffin2; Nancy Tausz, MPA1 (View author affiliations)
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Summary

What is already known about this topic?
Tuberculosis (TB) is a contagious airborne disease that can spread in congregate settings such as a school environment. Recommendations for testing contacts in these settings are to test those at highest risk for exposure, followed by evaluation of findings and expanding testing as needed. Persons who test positive for latent TB infection should be treated with an antibiotic course ranging from 12 weeks to 9 months to prevent the development of active TB disease.
What is added by this report?
Following identification of a case of infectious TB in a high school student in February 2015, 23 (92%) of 25 household and social contacts and 385 (91%) of 424 high school students and staff members who shared at least one class with the index patient completed TB testing. Among 50 persons who tested positive, all were medically screened, and started on treatment for latent TB infection; 48 (96%) completed treatment. Approximately half (54%) of the infected persons opted for 12 weekly doses of isoniazid and rifapentine treatment, which require directly observed therapy. A procedure was developed to allow these persons to use video directly observed therapy (VDOT) to successfully complete their treatment.
What are the implications for public health practice?
VDOT, which previously had only been used during treatment of persons with active TB disease, is a viable option that can reduce costs and the time involved for both TB staff members and patients, while maintaining high compliance and completion rates.

Elizabeth Lawlor Holzschuh, MS1; Stacie Province, MSN1; Krystle Johnson, MSN1; Caitlin Walls, MPH1; Cathy Shemwell1; Gary Martin, MPA1; Amy Showalter1; Jennifer Dunlay1; Andrew Conyers, MPA1; Phil Griffin2; Nancy Tausz, MPA1 (View author affiliations)
View suggested citation

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