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Treatment of latent tuberculosis infections in the Darwin region

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As it is estimated that one-third of the world population have a latent tuberculosis infection (LTBI), treatment to prevent active tuberculosis is an essential component of the World Health Organization “End TB Strategy”.1

To inform and evaluate practice, we undertook a cohort study of people in the Darwin region (estimated population, 140 000; 25% Indigenous Australians, 25% overseas-born residents) diagnosed with LTBI according to Northern Territory guidelines2 during June 2013 – July 2014. Diagnosis was based on a positive Mantoux test result2 and the absence of radiological and clinical evidence for active tuberculosis. Demographic and treatment acceptance and compliance data were collected from the sole treatment centre serving the region. The recommended therapy was 9 months’ treatment with isoniazid, or 4 months’ treatment with rifampicin if isoniazid was contraindicated.2 Treatment adherence was assessed monthly on the basis of clinic attendance, self-reported adherence, and collection of the medication.

During the study period, 573 people were diagnosed with LTBI, of whom 422 (74%) were overseas-born, 81 (14%) were Indigenous Australians, and 70 (12%) were non-Indigenous Australians. The age range was 0–77 years (median, 32 years); 61% were male. The proportions…