Charlotte Colvin, MA, PhD cand, International Health, Tulane University School of Public Health & Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, 504-988-1348, ccolvin@tulane.edu and Elisabeth Gleckler, MPH, DrPH, College of Education, Human Performance and Health Promotion, University of New Orleans, 109 Human Performance Building, UNO Lakefront Campus, New Orleans, LA 70148.

The case rates for tuberculosis (TB) in Louisiana have slowly decreased over the past few years, with the exception of Orleans parish. African American men are at particularly high risk for developing pulmonary TB. One strategy for decreasing case rates is identification and treatment of individuals with latent TB infection. In Louisiana, directly observed therapy (DOT) is mandated for active TB cases but not for LTBI due to resource constraints, with the exception of children with LTBI or children that are living with a TB case. The inability to provide follow up for individuals on IPT and ensure compliance is a serious weakness for the TB control program. There are a number of barriers to IPT treatment for people with LTBI – access to care, attitudes of care givers, low perception of the severity of TB, low perception of risk for developing active TB, belief that IPT is ineffective, insecurity about maintaining commitment to complete 6 months of treatment, and fear of side affects. The present study was initiated in New Orleans to investigate these and other potential barriers to compliance with IPT. The study entailed a multi-method approach, using existing TB records, interviews with TB control administrators, clinic staff, DIS officers, patients, observation in clinics and the field, and the input of a multi-disciplinary advisory group. The results of the study were used to develop interventions aimed at improving uptake of IPT among contacts and routine reactors and compliance among those who agree to initiate treatment.

Learning Objectives:

• Describe a process for improving community-based interventions to improve isoniazid preventive therapy for people with latent tuberculosis infection.
• Identify key barriers to completion of IPT among at-risk populations in New Orleans, Louisiana.

Keywords: Tuberculosis, Treatment Adherence

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.