Factors associated with non-adherence to tuberculosis preventive treatment among adult contacts of pulmonary tuberculosis cases with latent tuberculosis infection in catalonia, spain, in 2019−2021

The aim of this study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection for new cases of pulmonary TB cases reported in Catalonia in 2019-2021. All contacts aged 18 years or older with a latent TB infection who received a TB preventive treatment were included in the study. The Chi square test and the odds ratios (OR) were used to assess the association between non-adherence to TB preventive treatment and the study variables; a p < 0.05 was considered statistically significant. Multiple logistic regression analysis was used to detect the independent factors associated with TB preventive treatment non- adherence; a p < 0.05 was considered statistically significant. The percentage of non-adherence to TB preventive treatment found in this study was 23.7%. A multivariable logistic regression analysis determined that the following factors were significantly associated with TB preventive treatment non-adherence among adult contacts: "exposure at school or workplace" (aOR equivalent 3.34), "exposure to an index case without laboratory confirmation of TB" (aOR equivalent 2.07), "immigrant contact" (aOR equivalent 1.81), "male gender" (aOR equivalent 1.75) and "exposure duration < 6 h per week or sporadic" (aOR equivalent 1.60. By contrast, the factor "short-term TB preventive treatment regimen" (aOR equivalent 0.38) was significantly associated with a lower treatment non-adherence. Adherence to TB preventive treatment should be improved among adult contacts of TB pulmonary cases with latent TB infection by recommending short-term treatment regimens and by developing health education activities, with a greater focus on contacts with factors associated with treatment non-adherence.