Biomedical subjects

B DeVoe

Publications and source records attributed to B DeVoe.

4 recordsLinked to original sources

PubMed2001

Acceptability of short-course rifampin and pyrazinamide treatment of latent tuberculosis infection among jail inmates.

STUDY OBJECTIVES: To determine whether short-course treatment of latent tuberculosis infection (LTBI) with 2 months of rifampin and pyrazinamide (2RZ) is well tolerated and leads to increased treatment completion among jail inmates, a group who may benefit from targeted testing and treatment for LTBI but for whom completion of > or = 6 months of isoniazid treatment is difficult because of the short duration of incarceration. DESIGN: Prospective cohort. SETTING: Large, urban county jail. PATIENTS: All inmates admitted to the Fulton County Jail who had positive tuberculin skin test results, normal findings on chest radiography, and expected duration of incarceration of at least 60 days. INTERVENTION: Inmates were offered 2RZ via daily directly observed therapy for 60 doses as an alternative to isoniazid therapy. MEASUREMENTS AND RESULTS: We measured the completion of 2RZ treatment and toxicity due to 2RZ treatment during incarceration. From December 14, 1998, through December 13, 1999, 1,360 new inmates had positive tuberculin skin test results and normal findings on chest radiography, and 168 new inmates had an expected duration of incarceration of > or = 60 days. One hundred sixty-six inmates (> 99%) were HIV-negative. Eighty-one inmates (48%) completed 60 doses of 2RZ treatment while incarcerated. Seventy-four inmates (44%) were released before completion. Treatment was stopped in 1 inmate (< 1%) for asymptomatic elevation of asparginine aminotransferase (> or = 10 times normal) and in 12 inmates (7%) for minor complaints. Twenty-one inmates had completed isoniazid treatment in the year before the availability of 2RZ, and 9 inmates completed isoniazid treatment in the year during the availability of 2RZ. CONCLUSIONS: 2RZ was acceptable to and well tolerated by inmates, and led to a marked increase in the number of inmates completing treatment of LTBI during incarceration.

Adult↗

PubMed2001

A spoonful of sugar...: improving adherence to tuberculosis treatment using financial incentives.

OBJECTIVE: To determine whether incentives increase adherence to directly observed therapy (DOT) for tuberculosis (TB) treatment. METHODS: The TB program gave a five-dollar grocery coupon for each DOT appointment kept to 55 patients who had missed at least 25% of DOT doses over a 4-week period. Treatment completion rates were compared with an historic control group of 52 patients who began treatment a year earlier, who would have been eligible for incentives but did not receive them. RESULTS: Incentive program patients were more likely than control patients to complete therapy within 32 weeks (OR 5.73, 95%CI 2.25-14.84) and 52 weeks (OR 7.29, 95%CI 2.45-22.73). CONCLUSION: Patient incentives can increase adherence to DOT in TB programs.

Antitubercular Agents↗

PubMed1998

Outbreak of tuberculosis associated with a floating card game in the rural south: lessons for tuberculosis contact investigations.

We investigated an outbreak of tuberculosis disease and infection in a rural southern county in which an average of less than one case per year had occurred in the previous 10 years. Nine cases of tuberculosis developed. Reinterview 19 months after the patient with the initial case presented revealed that he had participated in an illegal floating card game with two of the other patients; numerous other unacknowledged social connections among the patients existed. Restriction fragment length polymorphism typing revealed that mycobacteria isolated from five of six available specimens matched; the patient from whom the nonmatched mycobacterium was isolated had a coincident relapsed case. The infection rate among contacts decreased as the investigation expanded to include more than one-third of the county residents: from 51% of those named initially to 2% of those at a school screening and from 68% of those named by more than one patient to 20% of those named by only one patient. Maintaining effective tuberculosis control programs in areas in which the incidence is low will be a challenge as rates of tuberculosis continue to decline nationwide.

Adolescent↗

PubMedDate not supplied

Tuberculosis case detection in a state prison system.

OBJECTIVE: This study was designed to describe the epidemiology of tuberculosis ((TB) among inmates in the Georgia state prison system; to evaluate the effectiveness of the TB case detection methods used; to evaluate the use of contact tracing for inmate TB cases; and to determine rates of completion of therapy. METHODS: Using a standardized form, the authors abstracted data from reports to the Centers for Disease Control and Prevention, prison hospital medical charts, and county health department records for all patients with TB treated in the Georgia Department of Corrections prison system from 1991 through 1995. RESULTS: A total of 142 cases of tuberculosis were treated in the prison during five-year period. Approximately two-thirds were detected by active case finding,either at the county jail prior to transfer to the prison system (31%) or at the prison intake evaluation (37%). Routine screening procedures at entry, following Centers for Disease Control and Prevention guidelines, had a sensitivity of 96%. Contact investigations were carried out in county jails or in the community for only 25% of cases detected at entry to prison. For those released from prison still on treatment, 38% were lost to follow-up before completion of therapy. CONCLUSIONS: The Georgia prison system is doing an effective job of TB case detection and treatment among incarcerated inmates. Closer cooperation between the prison system and local health departments is needed to improve contact tracing and completion of therapy for this high risk population. Some cases detected at entry to prison appear to have been missed in the county jails

Adult↗