Programmatic Effectiveness of Latent Tuberculosis Care Cascade in a Community Health Center

Our aim was to quantify successful completion of steps of the latent tuberculosis (LTBI) care cascade in a community health center (CHC) with a large foreign-born population. We conducted a retrospective cohort study of individuals with a positive test for tuberculosis (TB) infection from 2015 to 2017 at Baltimore Medical Systems (BMS). During the study period, 3,984 individuals were tested for TB. Of the 418 individuals with positive tests, 152 (36%) were referred elsewhere for care, whereas 266 (64%) were retained in care at BMS. Treatment was prescribed for 157 of the 214 (73%) diagnosed with LTBI and retained in care at BMS (125/157 [80%] four months of rifampin; 32/157 [20%] nine months of isoniazid). One hundred forty-one patients (141/157, 90%) initiated treatment, of which 119 completed therapy (119/141, 84%). Our study identified several gaps in the LTBI care cascade in a CHC. Nonetheless, a large proportion of those treated for LTBI at the CHC completed therapy.