Date of Award

2026-05-22

Degree Name

PhD Nursing

Dissertation Committee

Sheree Scott, PhD, RN, AGCNS-BC, CMSRN, CNL, Chairperson; Caroline Etland, PhD, RN, CNS, ACHPN, Committee Member; Cynthia D. Connelly, PhD, RN, FAAN, Committee Member

Keywords

LTBI, adherence, treatment, contact, failing.

Abstract

Abstract

Background: The World Health Organization, Centers for Disease Control and Prevention, and European Centre for Disease Prevention and Control estimated at least a quarter of the world’s population is infected with Latent Tuberculosis Infection (LTBI). These organizations suggest about 10% of people with LTBI will develop active Tuberculosis (TB) in their lifetime. The literature suggests 50%‒65% of patients fail to complete LTBI treatment. Current research is inconsistent and often contradictory on the variables most associated with failed LTBI adherence. Understanding why patients fail to complete treatment will impact the World Health Organization TB Elimination Strategy.

Study Population: The study sample consisted of adults, ages 18 to 65 years, who were contacts to an active TB case between 2018‒2024 with a positive TB test, negative chest X-ray, and prescribed a standard LTBI regimen.

Purpose/Aims: To examine select sociodemographic, medical, and LTBI variables and their effect on patients failing to complete LTBI treatment.

Methods: Retrospective, correlational, cross-sectional design, focused on data from diverse individuals at two time-points—treatment initiation and discontinuation. Data from a public health TB contact database was analyzed (N = 3,166). Descriptives characterized the sample; chi-square analyses described the relationships between variables. Binomial logistic regression identified the amount of variance for variables with statistically significant associations.

Results: Three factors significantly contributed to failure to complete treatment in the study sample: Final classification (p = .042), treatment status (p < .001), and present treatment medication (p = .006). Notably, the protective effect on failure to complete treatment from Present Treatment Medication showed that shorter treatment regimens were much more effective to prevent failure to complete treatment.

Implications: Why patients fail to complete treatment is a complex issue and needs to be addressed at the personal level. Accurate data collection and qualitative analysis is needed to further explore associations between why an individual would fail to complete LTBI treatment.

Document Type

Dissertation: Open Access

Department

Nursing

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