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School-based tuberculosis testing and treatment program: comparing directly observed preventive therapy with
P Sass1, K Cooper, V Robertson
1Department of Family Practice, State University of New York Health Science Center at Brooklyn, USA.
Journal of Public Health Management and Practice : JPHMP
|February 1, 1997
Summary
Directly observed preventive therapy (DOPT) significantly improved tuberculosis treatment compliance in high school students compared to traditional methods. This school-based tuberculosis testing and treatment program demonstrated effectiveness and efficiency.
Area of Science:
- Public Health
- Infectious Disease Control
- Adolescent Health
Background:
- Tuberculosis (TB) remains a significant public health concern, particularly in school settings.
- Ensuring compliance with preventive therapy for latent tuberculosis infection is crucial for disease control.
- Traditional treatment models may face challenges in adherence among adolescents.
Purpose of the Study:
- To compare the compliance rates of purified protein derivative (PPD) positive students undergoing isonicotinic hydrazine (INH) preventive therapy.
- To evaluate the effectiveness of Directly Observed Preventive Therapy (DOPT) versus traditional therapy in a high school population.
- To assess the feasibility of school-based tuberculosis testing and treatment programs.
Main Methods:
- A high-school-based health center implemented a TB testing and treatment program.
- Purified protein derivative (PPD) testing was administered to students.
- Students positive for PPD were assigned to either Directly Observed Preventive Therapy (DOPT) or traditional therapy groups.
- Compliance rates were compared between the two groups.
Main Results:
- Of 436 students tested, 209 (49%) had a positive PPD test; positivity rates were consistent across age, sex, and duration of US residency.
- No association was found between BCG vaccination and PPD positivity or induration size.
- Compliance with DOPT (54%) was significantly higher than with traditional therapy (26%).
- First and second attempt completion rates for DOPT reached 71%; Haitian students showed higher completion than Jamaican students.
Conclusions:
- Directly Observed Preventive Therapy (DOPT) is a more effective and efficient strategy for tuberculosis preventive therapy in high school students.
- School-based health centers provide a viable setting for implementing and managing tuberculosis testing and treatment programs.
- Targeted interventions like DOPT can improve treatment adherence in adolescent populations.