Acceptance of isoniazid preventive treatment by close contacts of tuberculosis cases: a 692-subject Italian study.

ABSTRACT

SETTING: Villa Marelli Institute, Lombardy Regional Reference Centre for Tuberculosis. OBJECTIVE: To evaluate acceptance of and adherence to isoniazid preventive treatment (IPT) of close contacts of contagious tuberculosis (TB) cases (CC); comparison of Italian and immigrant patients. METHODS: A retrospective study of a consecutive series of 692 subjects (474 Italians and 218 immigrants from developing countries) exposed to contagious TB cases, who were offered IPT after tuberculin skin testing and chest X-ray, according to the Lombardy Regional Protocol for TB control. RESULTS: Of 692 CCs, 36 (5.2%) subjects refused IPT, 522 (75.5%) completed the treatment as prescribed, 23 (3.3%) suspended IPT because of adverse effects, 14 (2.0%) spontaneously discontinued IPT against our advice, 93 (13.4%) were lost to follow up, and seven (0.6%) were still in treatment when the present data were evaluated. Italian CCs had a completion rate significantly higher than the immigrants (81.0% vs 63.3%, P < 0.01). CONCLUSION: The rate of acceptance and completion of IPT in our population proved higher than many previously reported data, and the better results among Italian subjects reflect the importance of a complete comprehension of IPT that may not always be achieved with immigrant patients.