Improving latent tuberculosis infection treatment completion rates in refugee communities through the use of organized education, outreach and follow-up

Several counties in California that receive refugees face issues surrounding treatment compliance for latent tuberculosis infection (LTBI). Within California, there is a high rate of LTBI with a low rate (sometimes 15%) of voluntary treatment completion among refugees. Some refugee populations have beliefs, both personal and religious, against the use of medications, particularly to treat LTBI. Refugees have differences in culture, values and beliefs that vary significantly from Western health practices and religious convictions. The concept of prevention services remains difficult for many new refugees to understand and to accept. These beliefs may interfere with health care treatment, medications and testing for LTBI.

Through outreach activities such as providing culturally appropriate health education by culturally and linguistically competent staff; networking; and the use of home visits and incentives programs have been able to significantly increase the TB treatment completion rate. Tracking systems have been implemented to strengthen LTBI follow-up, in addition to other services, such as providing interpreter and transportation. As a result of these focused activities and educational interventions, there has been a measurable increase in the rate of LTBI completion from 15% to 77%.