Treating Latent Tuberculosis Infection in Newly Arriving Refugees: An Advanced Practice Nurse Initiative at the University of Louisville Global Health Center

Abstract

Background: A review of newly arriving refugees referred to the local health department for latent tuberculosis infection (LTBI) treatment during 2013-2015 revealed a treatment gap of 73%, supporting the need to identify new approaches to treat vulnerable populations and mirrored results in the literature. Objectives: 1) Describe an advanced practice registered nurse (APRN) led alternative approach to LTBI treatment in the refugee population; and 2) evaluate the impact of a 12-week regimen for LTBI on treatment acceptance, adherence and completion. Methods: During the initial health screening visit, treatment options were provided for those identified with LTBI consisting of either a 12-week regimen requiring weekly directly observed therapy (DOT) or the traditional 9-month treatment. Results: During March-December 2016, 50 refugees were referred and 24/50 were offered a 12week regimen of Rifapentine and Isoniazid, administered with DOT. 23 of the 24 or 96% completed the entire treatment course. Conclusions: The new LTBI clinic process resulted in an increase in treatment acceptance and completion compared with the historic rate of 27%. Implications for Nursing: APRN initiatives such as this can result in positive benefits to patients and communities while serving to advance the nursing profession in all practice settings DOI: 10.18297/rgh/vol3/iss1/x Submitted Date: xxxxxx Accepted Date: xxxxxx Website: https://ir.library.louisville.edu/rgh Affiliations: 1University of Louisville, Division of Infectious Diseases 2Northern Kentucky University, College of Health Professions, Department of Advanced Nursing Studies 3Harvard University Recommened Citation: Goss, Linda; Balcom, Dawn; Mutsch, Karen; Carrico, Ruth; and Bosson, Rahel (2019) “Treating Latent Tuberculosis Infection in Newly Arriving Refugees: An Advanced Practice Nurse Initiative at the University of Louisville Global Health Center,” Journal of Refugee & Global Health: Vol. 3 : Iss. 1 , Article 1. This original article is brought to you for free and open access by ThinkIR: The University of Louisville’s Institutional Repository. It has been accepted for inclusion in The University of Louisville Journal of Respiratory Infections by an authorized editor of ThinkIR. For more information, please contact thinkir@louisville. edu *Correspondence To: Linda Goss, DNP Work Email: linda.goss@louisville.edu