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Differences in TB beliefs between foreign-born and US-born patients

Rita Sondengam1, Yael Hirsch-Moverman, MPH2, Paul Colson, PhD2, Sharon B. Mannheimer, MD3, Nancy Holson, MPH1, and Wafaa M. El-Sadr, MD, MPH4. (1) Division of Infectious Diseases, Harlem Hospital/Columbia University, 506 Lenox Avenue, MLK Building, RM 3101A, New York, NY 10037, 212 939 2381, rs2227@columbia.edu, (2) Charles P. Felton National Tuberculosis Center, 2238 Fifth Avenue, First Floor, New York, NY 10037, (3) Harlem Hospital Center, Columbia University College of Physicians and Surgeons, 506 Lenox Ave, Room 3101A, New York, NY 10037, (4) Division of Infectious Diseases, Mailman School of Public Health at Columbia Universtiy and Harlem Hospital, Harlem Hospital 506 Lenox Avenue, 506 Lenox Avenue, Room 3101A, New York, NY 10037

Background: Latent tuberculosis infection (LTBI) treatment is an important strategy to control TB in high-risk populations. Factors that may influence acceptance of treatment (tx) include: pt knowledge, attitudes and perceptions of benefits and barriers regarding LTBI. We compared knowledge, attitudes and perceptions among a high-risk population, foreign-born (FB) and US-born pts. Methods: Pts prescribed LTBI tx were enrolled in an on-going randomized clinical trial. Knowledge, attitudes and perceptions of benefits and barriers were assessed at baseline. Items measuring perceived benefits and barriers to tx were combined into scales with acceptable internal consistency. Results: 167 pts were interviewed; 61% were FB. Significant demographic differences included: US-born were more likely to have a history of homelessness (56.9% vs. 23.8%, p<.001), and fewer had received BCG vaccine (35.4% vs. 73.5%, p<.001). Significant attitudinal differences included: FB were more likely to feel protected against TB disease (56.6% vs 31.7%, p=.002), and were less likely to believe they had the TB germ (64.4% vs 82.8%, p=.010). FB were more likely to say they had no time to go to the clinic (14.9% vs 4.7%, p=.044), and felt it was too difficult to take medicine regularly (23.7% vs 4.6%, p=.001). FB perceived significantly more barriers regarding treatment of LTBI than US-born (2.18±.37 vs 2.04±.36, p=.024). Overall LTBI knowledge and perceived benefits of tx were not found to be significantly different between US-born and FB. Conclusion: Substantial attitudinal differences were noted between FB and US-born. These issues should be taken into account in designing LTBI treatment programs.

Learning Objectives:

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.

Epidemiology of Chronic Disease, STDs and TB

The 132nd Annual Meeting (November 6-10, 2004) of APHA