Use of Video Directly Observed Therapy for Treatment of Latent Tuberculosis Infection - Johnson County, Kansas, 2015
Use of Video Directly Observed Therapy for Treatment of Latent Tuberculosis Infection - Johnson County, Kansas, 2015
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DOI：
10.15585/mmwr.mm6614a3
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发表时间：
2017-04-14
影响因子：
33.9
通讯作者：
Tausz, Griffin Nancy
中科院分区：
文献类型：
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作者：
Holzschuh, Elizabeth Lawlor;Province, Stacie;Tausz, Griffin Nancy
关于这个话题我们已经知道了什么？结核病是一种通过空气传播的传染病，可以在学校等聚集环境中传播。在这些环境中检测接触者的建议是检测暴露风险最高的接触者，然后对结果进行评价，并根据需要扩大检测范围。潜伏性结核感染测试呈阳性的人应接受12周至9个月的抗生素疗程治疗，以防止活动性结核病的发展。本报告补充了什么？在2015年2月发现一名高中生感染结核病后，25名家庭和社会接触者中有23人（92%）和424名高中生和工作人员中有385人（91%）与指示患者共享至少一个班级完成了结核病检测。在检测呈阳性的50人中，所有人都接受了医学筛查，并开始治疗潜伏性结核感染; 48人（96%）完成了治疗。大约一半（54%）的感染者选择了每周12次的异烟肼和利福喷丁治疗，这需要直接观察治疗。开发了一种程序，允许这些人使用视频直接观察治疗（VDOT），以成功地完成他们的治疗。什么是公共卫生实践的影响？VDOT以前只用于治疗活动性结核病患者，现在是一个可行的选择，可以减少结核病工作人员和患者的费用和时间，同时保持较高的依从率和完成率。
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.