ArticlePloS one2021
Closing delivery gaps in the treatment of tuberculosis infection: Lessons from implementation research in Peru.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Challenges and Opportunities for Improved Tuberculosis and HIV Prevention in South America.Open forum infectious diseases · 2026Review
- Tuberculosis in Spain: An opinion paper.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Review
- Article
- Testing and Scaling Interventions to Improve the Tuberculosis Infection Care Cascade.Journal of the Pediatric Infectious Diseases Society · 2022Review
- Article
- Mapping local hot spots with routine tuberculosis data: A pragmatic approach to identify spatial variability.PloS one · 2022Article
- A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking.BMJ global health · 2021Article
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundTargeted testing and treatment of TB infection to prevent disease is a pillar of TB elimination. Despite recent global commitments to greatly expand access to preventive treatment for TB infection, there remains a lack of research on how best to expand preventive treatment programs in settings with high TB burdens.
methodsWe conducted implementation research in Lima, Peru, around a multifaceted intervention to deliver TB preventive treatment to close contacts of all ages, health care workers, and people in congregate settings. Key interventions included use of the interferon gamma release assay (IGRA), specialist support for generalist physicians at primary-level health facilities, and treatment support by community health workers. We applied a convergent mixed methods approach to evaluate feasibility and acceptability based on a care cascade framework.
findingsDuring April 2019-January 2020, we enrolled 1,002 household contacts, 148 non-household contacts, 107 residents and staff of congregate settings, and 357 health care workers. Cumulative completion of the TB preventive care cascade was 34% for contacts <5 years old, 28% for contacts 5-19 years old, 18% for contacts ≥20 years old, 0% for people in congregate settings, and 4% of health care workers. IGRA testing was acceptable to adults exposed to TB. Preventive treatment was acceptable to contacts, but less acceptable to physicians, who frequently had doubts about prescribing preventive treatment for adults. Community-based treatment support was both acceptable and feasible, and periodic home-visits or calls were identified as facilitators of adherence.
conclusionsWe attempted to close the gap in TB preventive treatment in Peru by expanding preventive services to adult contacts and other risk groups. While suboptimal, care cascade completion for adult contacts was consistent with what has been observed in high-income settings. The major losses in the care cascade occurred in completing evaluations and having doctors prescribe preventive treatment.
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