Socioeconomic support to improve initiation of tuberculosis preventive therapy and increase tuberculosis treatment success in Peru: a household-randomised, controlled evaluation

摘要: Abstract Background For the first time in modern era of tuberculosis control, WHO's End TB strategy specifically integrates socioeconomic support for people affected by with existing biomedical interventions. However, there is little evidence impact this approach on outcomes. We designed and implemented one world's tuberculosis-specific interventions, assessed its prevention measures treatment success, refined use Community Randomized Evaluation a Socioeconomic Intervention to Prevent Tuberculosis (CRESIPT) project. Methods This unmasked household-randomised controlled study was done 32 peri-urban shanty towns Callao, Peru. Households patients treated Peru's Program were randomly assigned (1:1, computer-assisted randomisation) receive Peruvian standard care (control group) or additionally (intervention group). consisted conditional cash transfers (≤US$230) social (household visits community meetings). Primary outcome initiation preventive therapy contacts younger than 20 years available follow-up assessment. 400 needed 80% power at 95% (two-sided) confidence level detect 50% increase primary outcome. Secondary success intention treat. Ethics approval given ethics committees DIRESA Callao (Regional Ministry Health) Asociacion Benefica PRISMA, Lima, Peru, Imperial College London, UK. All participants gave written informed consent. has been registered ISCTRN registry, number pending. Findings From Feb 10 Aug 14, 2014, 282 (410 eligible contacts) recruited. 135 randomised intervention group (206 147 control (204 contacts). Follow-up continued June 30, 2015. Compared controls, more likely start (91/206 [44%] vs 53/204 [26%], adjusted odds ratio 2·2 [95% CI 1·1–4·2]; p=0·02); have (87 [64%] 78 [53%], 1·8 [1·1–2·9]; p=0·02). Interpretation Tuberculosis-specific improved success. The CRESIPT will now evaluate control. Funding Joint Global Health Trials consortium Wellcome Trust, Medical Research Council, Department International Development; British Infection Association; Bill Melinda Gates Foundation; Innovation And Trust.