A randomized controlled study of socioeconomic support to enhance tuberculosis prevention and treatment, Peru

Wingfield, Tom ORCID: https://orcid.org/0000-0001-8433-6887, Tovar, Marco A, Huff, Doug, Boccia, Delia, Montoya, Rosario, Ramos, Eric, Datta, Sumona, Saunders, Matthew J, Lewis, James J, Gilman, Robert H and Evans, Carlton A (2017) 'A randomized controlled study of socioeconomic support to enhance tuberculosis prevention and treatment, Peru'. Bulletin of the World Health Organization, Vol 95, Issue 4, pp. 270-280.

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Abstract

Objective To evaluate the impact of socioeconomic support on tuberculosis preventive therapy initiation in household contacts of
tuberculosis patients and on treatment success in patients.
Methods A non-blinded, household-randomized, controlled study was performed between February 2014 and June 2015 in 32 shanty
towns in Peru. It included patients being treated for tuberculosis and their household contacts. Households were randomly assigned to either
the standard of care provided by Peru’s national tuberculosis programme (control arm) or the same standard of care plus socioeconomic
support (intervention arm). Socioeconomic support comprised conditional cash transfers up to 230 United States dollars per household,
community meetings and household visits. Rates of tuberculosis preventive therapy initiation and treatment success (i.e. cure or treatment
completion) were compared in intervention and control arms.
Findings Overall, 282 of 312 (90%) households agreed to participate: 135 in the intervention arm and 147 in the control arm. There were
410 contacts younger than 20 years: 43% in the intervention arm initiated tuberculosis preventive therapy versus 25% in the control arm
(adjusted odds ratio, aOR: 2.2; 95% confidence interval, CI: 1.1–4.1). An intention-to-treat analysis showed that treatment was successful
in 64% (87/135) of patients in the intervention arm versus 53% (78/147) in the control arm (unadjusted OR: 1.6; 95% CI: 1.0–2.6). These
improvements were equitable, being independent of household poverty.
Conclusion A tuberculosis-specific, socioeconomic support intervention increased uptake of tuberculosis preventive therapy and
tuberculosis treatment success and is being evaluated in the Community Randomized Evaluation of a Socioeconomic Intervention to
Prevent TB (CRESIPT) project.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.2471/BLT.16.170167
Depositing User:	Stacy Murtagh
Date Deposited:	09 Dec 2020 16:34
Last Modified:	09 Dec 2020 16:35
URI:	https://archive.lstmed.ac.uk/id/eprint/16349

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