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  1. Tuberculosis prophylaxis in the homeless : a trial to improve adherence to referral.

    Article - En anglais

    Background 

    Adherence to tuberculosis evaluation is poor in a high-risk population such as the homeless.

    Objective 

    To test two interventions aimed at improving adherence to tuberculosis evaluation and to identify predictors of adherence.

    Methods 

    We conducted a randomized clinical trial in shelters and food lines in the inner city of San Francisco, Calif.

    We randomized 244 eligible subjects infected with tuberculosis to (1) peer health adviser (assistance by a peer [n=83]), (2) monetary incentive ($5 payment [n=82]), or (3) usual care (referral slips and bus tokens only [n=79]). The primary outcome of the study was adherence to a first follow-up appointment at the tuberculosis clinic, where subjects were evaluated for active tuberculosis and the need for isoniazid prophylaxis.

    Results 

    Of the subjects assigned to a monetary incentive, 69 (84%) completed their first follow-up appointment, compared with 62 subjects (75%) assigned to a peer health adviser and 42 subjects (53%) assigned to usual care.

    Adherence was higher in the monetary incentive and peer health adviser groups than in the usual care group (P<. 001 and P=004, respectively).

    Patients not using intravenous drugs and patients 50 years of age or older were more likely to adhere to a first follow-up appointment (odds ratios [95% confidence intervals], 2.5 [1.3 to 5.0] and 3.3 [1.2 to 8.8], respectively).

    Among the 173 tuberculosis-infected subjects who completed their appointment, isoniazid th...

    Mots-clés Pascal : Tuberculose, Poumon, Sans domicile fixe, Prévention, Epidémiologie, Homme, Mycobactériose, Bactériose, Infection, Appareil respiratoire pathologie, Poumon pathologie

    Mots-clés Pascal anglais : Tuberculosis, Lung, Homeless, Prevention, Epidemiology, Human, Mycobacterial infection, Bacteriosis, Infection, Respiratory disease, Lung disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0109738

    Code Inist : 002B30A03B. Création : 199608.