Adherence to nine-month isoniazid for latent tuberculosis infection in healthcare workers: a prospective study in a tertiary hospital
Poor adherence to medication can lead to treatment failure in healthcare workers (HWCs) with latent tuberculosis infection (LTBI) who are at high risk of developing active tuberculosis. However, the factors associated with non-completion of nine-month LTBI treatment with isoniazid (9 H) have not bee...
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| creator | Chung, Sung Jun Lee, Hyun Koo, Gun Woo Min, Ji-Hee Yeo, Yoomi Park, Dong Won Park, Tai Sun Moon, Ji-Yong Kim, Sang-Heon Kim, Tae Hyung Sohn, Jang Won Yoon, Ho Joo |
| description | Poor adherence to medication can lead to treatment failure in healthcare workers (HWCs) with latent tuberculosis infection (LTBI) who are at high risk of developing active tuberculosis. However, the factors associated with non-completion of nine-month LTBI treatment with isoniazid (9 H) have not been well studied. We investigated the completion rate and factors affecting adherence to LTBI treatment with 9 H among HCWs. A prospective cohort study of 114 HCWs who were diagnosed with LTBI by QuantiFERON-TB Gold In-Tube tests were performed in a single university hospital between June 2016 and December 2017. All patients received the 9 H LTBI treatment. At each visit, treatment adherence and development of adverse reactions to isoniazid were evaluated via a standard questionnaire. To evaluate the impact of the severity of hepatotoxicity on non-completion of LTBI treatment, we classified hepatotoxicity into two groups: severe hepatotoxicity was defined as alanine aminotransferase >3.0 times the upper normal limit (UNL) with symptoms or = 5.0 times the UNL. Mild hepatotoxicity was defined as alanine aminotransferase>UNL, but not meet the definition of severe hepatotoxicity. Overall, 71 HCWs (62.3%) completed LTBI treatment with 9 H while 43 HCWs (37.7%) discontinued their treatment. Most discontinuation (81.4%, 35/43) occurred during the first three months of treatment. There were no significant differences in age, sex, occupation, or comorbidities between the HCWs who completed and those who discontinued LTBI treatment. However, HCWs who discontinued LTBI treatment had more hepatotoxicity than those who completed treatment (44.2% vs. 11.3%,
P
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| doi_str_mv | 10.1038/s41598-020-63156-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7160120</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2390142981</sourcerecordid><originalsourceid>FETCH-LOGICAL-c522t-15ca7c99ec90e5d2bc9528669f507697ced3b850c690f3683cdfd509435d2a7e3</originalsourceid><addsrcrecordid>eNp9kU1LJDEQhoO4rOL6B_YgAc-t-eikOx4EEb9A2MvuOWTS1Xa0JxmTtDLe_d9mHD8vm0uKqqfequJF6DclB5Tw9jDVVKi2IoxUklMhq3YDbTNSi4pxxja_xFtoN6VbUp5gqqbqJ9oqWSWJktvo-aQbIIK3gHPA3nmo5sHnAbsUvDNPrsN9iHg0GXzGeZpBtNMYkkvY-R5sdsGXCA9gxjxYEwE_hngHMR1hgxcxpMUKegCc8tQtV6jBGWJ2Ji7xUMoum_EX-tGbMcHu27-D_p2f_T29rK7_XFydnlxXVjCWKyqsaaxSYBUB0bGZVYK1UqpekEaqxkLHZ60gVirSc9ly2_WdIKrmBTYN8B10vNZdTLM5dLbcFM2oF9HNyzo6GKe_V7wb9E140A2VhDJSBPbfBGK4nyBlfRum6MvOmnFFaM1USwvF1pQt96cI_ccESvTKPb12Txf39Kt7ui1Ne193-2h596oAfA2kUvI3ED9n_0f2BW1qqSA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2390142981</pqid></control><display><type>article</type><title>Adherence to nine-month isoniazid for latent tuberculosis infection in healthcare workers: a prospective study in a tertiary hospital</title><source>MEDLINE</source><source>Nature Free</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>Free Full-Text Journals in Chemistry</source><source>Springer Nature OA Free Journals</source><creator>Chung, Sung Jun ; Lee, Hyun ; Koo, Gun Woo ; Min, Ji-Hee ; Yeo, Yoomi ; Park, Dong Won ; Park, Tai Sun ; Moon, Ji-Yong ; Kim, Sang-Heon ; Kim, Tae Hyung ; Sohn, Jang Won ; Yoon, Ho Joo</creator><creatorcontrib>Chung, Sung Jun ; Lee, Hyun ; Koo, Gun Woo ; Min, Ji-Hee ; Yeo, Yoomi ; Park, Dong Won ; Park, Tai Sun ; Moon, Ji-Yong ; Kim, Sang-Heon ; Kim, Tae Hyung ; Sohn, Jang Won ; Yoon, Ho Joo</creatorcontrib><description>Poor adherence to medication can lead to treatment failure in healthcare workers (HWCs) with latent tuberculosis infection (LTBI) who are at high risk of developing active tuberculosis. However, the factors associated with non-completion of nine-month LTBI treatment with isoniazid (9 H) have not been well studied. We investigated the completion rate and factors affecting adherence to LTBI treatment with 9 H among HCWs. A prospective cohort study of 114 HCWs who were diagnosed with LTBI by QuantiFERON-TB Gold In-Tube tests were performed in a single university hospital between June 2016 and December 2017. All patients received the 9 H LTBI treatment. At each visit, treatment adherence and development of adverse reactions to isoniazid were evaluated via a standard questionnaire. To evaluate the impact of the severity of hepatotoxicity on non-completion of LTBI treatment, we classified hepatotoxicity into two groups: severe hepatotoxicity was defined as alanine aminotransferase >3.0 times the upper normal limit (UNL) with symptoms or = 5.0 times the UNL. Mild hepatotoxicity was defined as alanine aminotransferase>UNL, but not meet the definition of severe hepatotoxicity. Overall, 71 HCWs (62.3%) completed LTBI treatment with 9 H while 43 HCWs (37.7%) discontinued their treatment. Most discontinuation (81.4%, 35/43) occurred during the first three months of treatment. There were no significant differences in age, sex, occupation, or comorbidities between the HCWs who completed and those who discontinued LTBI treatment. However, HCWs who discontinued LTBI treatment had more hepatotoxicity than those who completed treatment (44.2% vs. 11.3%,
P
< 0.001). Cox proportional hazard analysis revealed that hepatotoxicity is the only factor significantly associated with discontinuation of 9 H LTBI treatment (unadjusted HR = 2.89, 95% CI = 1.62–5.46). In multivariable analysis, not only severe hepatotoxicity (adjusted HR = 7.99, 95% CI = 3.05–20.94) but also mild hepatotoxicity was significantly associated with discontinuation of LTBI treatment (adjusted HR = 2.34, 95% CI = 1.05–5.21). The completion rate of 9 H LTBI treatment was 62.3% among HCWs. While age, sex, occupation, and pretreatment comorbidities were not associated with treatment completion, isoniazid-induced hepatotoxicity significantly affected adherence.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-63156-8</identifier><identifier>PMID: 32296096</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; 692/699/255/1856 ; Adult ; Alanine ; Alanine transaminase ; Alanine Transaminase - blood ; Antitubercular Agents - administration & dosage ; Antitubercular Agents - adverse effects ; Chemical and Drug Induced Liver Injury - blood ; Chemical and Drug Induced Liver Injury - diagnosis ; Chemical and Drug Induced Liver Injury - epidemiology ; Chemical and Drug Induced Liver Injury - etiology ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Health Personnel - statistics & numerical data ; Hepatotoxicity ; Humanities and Social Sciences ; Humans ; Isoniazid ; Isoniazid - administration & dosage ; Isoniazid - adverse effects ; Latent Tuberculosis - diagnosis ; Latent Tuberculosis - drug therapy ; Liver - drug effects ; Liver - enzymology ; Male ; Medical personnel ; Medication Adherence - statistics & numerical data ; Middle Aged ; multidisciplinary ; Prospective Studies ; Risk Factors ; Science ; Science (multidisciplinary) ; Severity of Illness Index ; Tertiary Care Centers - statistics & numerical data ; Time Factors ; Tuberculosis</subject><ispartof>Scientific reports, 2020-04, Vol.10 (1), p.6462, Article 6462</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-15ca7c99ec90e5d2bc9528669f507697ced3b850c690f3683cdfd509435d2a7e3</citedby><cites>FETCH-LOGICAL-c522t-15ca7c99ec90e5d2bc9528669f507697ced3b850c690f3683cdfd509435d2a7e3</cites><orcidid>0000-0001-8636-446X ; 0000-0001-7132-2988</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160120/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160120/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,41096,42165,51551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32296096$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chung, Sung Jun</creatorcontrib><creatorcontrib>Lee, Hyun</creatorcontrib><creatorcontrib>Koo, Gun Woo</creatorcontrib><creatorcontrib>Min, Ji-Hee</creatorcontrib><creatorcontrib>Yeo, Yoomi</creatorcontrib><creatorcontrib>Park, Dong Won</creatorcontrib><creatorcontrib>Park, Tai Sun</creatorcontrib><creatorcontrib>Moon, Ji-Yong</creatorcontrib><creatorcontrib>Kim, Sang-Heon</creatorcontrib><creatorcontrib>Kim, Tae Hyung</creatorcontrib><creatorcontrib>Sohn, Jang Won</creatorcontrib><creatorcontrib>Yoon, Ho Joo</creatorcontrib><title>Adherence to nine-month isoniazid for latent tuberculosis infection in healthcare workers: a prospective study in a tertiary hospital</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>Poor adherence to medication can lead to treatment failure in healthcare workers (HWCs) with latent tuberculosis infection (LTBI) who are at high risk of developing active tuberculosis. However, the factors associated with non-completion of nine-month LTBI treatment with isoniazid (9 H) have not been well studied. We investigated the completion rate and factors affecting adherence to LTBI treatment with 9 H among HCWs. A prospective cohort study of 114 HCWs who were diagnosed with LTBI by QuantiFERON-TB Gold In-Tube tests were performed in a single university hospital between June 2016 and December 2017. All patients received the 9 H LTBI treatment. At each visit, treatment adherence and development of adverse reactions to isoniazid were evaluated via a standard questionnaire. To evaluate the impact of the severity of hepatotoxicity on non-completion of LTBI treatment, we classified hepatotoxicity into two groups: severe hepatotoxicity was defined as alanine aminotransferase >3.0 times the upper normal limit (UNL) with symptoms or = 5.0 times the UNL. Mild hepatotoxicity was defined as alanine aminotransferase>UNL, but not meet the definition of severe hepatotoxicity. Overall, 71 HCWs (62.3%) completed LTBI treatment with 9 H while 43 HCWs (37.7%) discontinued their treatment. Most discontinuation (81.4%, 35/43) occurred during the first three months of treatment. There were no significant differences in age, sex, occupation, or comorbidities between the HCWs who completed and those who discontinued LTBI treatment. However, HCWs who discontinued LTBI treatment had more hepatotoxicity than those who completed treatment (44.2% vs. 11.3%,
P
< 0.001). Cox proportional hazard analysis revealed that hepatotoxicity is the only factor significantly associated with discontinuation of 9 H LTBI treatment (unadjusted HR = 2.89, 95% CI = 1.62–5.46). In multivariable analysis, not only severe hepatotoxicity (adjusted HR = 7.99, 95% CI = 3.05–20.94) but also mild hepatotoxicity was significantly associated with discontinuation of LTBI treatment (adjusted HR = 2.34, 95% CI = 1.05–5.21). The completion rate of 9 H LTBI treatment was 62.3% among HCWs. While age, sex, occupation, and pretreatment comorbidities were not associated with treatment completion, isoniazid-induced hepatotoxicity significantly affected adherence.</description><subject>692/308/409</subject><subject>692/699/255/1856</subject><subject>Adult</subject><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Alanine Transaminase - blood</subject><subject>Antitubercular Agents - administration & dosage</subject><subject>Antitubercular Agents - adverse effects</subject><subject>Chemical and Drug Induced Liver Injury - blood</subject><subject>Chemical and Drug Induced Liver Injury - diagnosis</subject><subject>Chemical and Drug Induced Liver Injury - epidemiology</subject><subject>Chemical and Drug Induced Liver Injury - etiology</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health Personnel - statistics & numerical data</subject><subject>Hepatotoxicity</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Isoniazid</subject><subject>Isoniazid - administration & dosage</subject><subject>Isoniazid - adverse effects</subject><subject>Latent Tuberculosis - diagnosis</subject><subject>Latent Tuberculosis - drug therapy</subject><subject>Liver - drug effects</subject><subject>Liver - enzymology</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Severity of Illness Index</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><subject>Time Factors</subject><subject>Tuberculosis</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU1LJDEQhoO4rOL6B_YgAc-t-eikOx4EEb9A2MvuOWTS1Xa0JxmTtDLe_d9mHD8vm0uKqqfequJF6DclB5Tw9jDVVKi2IoxUklMhq3YDbTNSi4pxxja_xFtoN6VbUp5gqqbqJ9oqWSWJktvo-aQbIIK3gHPA3nmo5sHnAbsUvDNPrsN9iHg0GXzGeZpBtNMYkkvY-R5sdsGXCA9gxjxYEwE_hngHMR1hgxcxpMUKegCc8tQtV6jBGWJ2Ji7xUMoum_EX-tGbMcHu27-D_p2f_T29rK7_XFydnlxXVjCWKyqsaaxSYBUB0bGZVYK1UqpekEaqxkLHZ60gVirSc9ly2_WdIKrmBTYN8B10vNZdTLM5dLbcFM2oF9HNyzo6GKe_V7wb9E140A2VhDJSBPbfBGK4nyBlfRum6MvOmnFFaM1USwvF1pQt96cI_ccESvTKPb12Txf39Kt7ui1Ne193-2h596oAfA2kUvI3ED9n_0f2BW1qqSA</recordid><startdate>20200415</startdate><enddate>20200415</enddate><creator>Chung, Sung Jun</creator><creator>Lee, Hyun</creator><creator>Koo, Gun Woo</creator><creator>Min, Ji-Hee</creator><creator>Yeo, Yoomi</creator><creator>Park, Dong Won</creator><creator>Park, Tai Sun</creator><creator>Moon, Ji-Yong</creator><creator>Kim, Sang-Heon</creator><creator>Kim, Tae Hyung</creator><creator>Sohn, Jang Won</creator><creator>Yoon, Ho Joo</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8636-446X</orcidid><orcidid>https://orcid.org/0000-0001-7132-2988</orcidid></search><sort><creationdate>20200415</creationdate><title>Adherence to nine-month isoniazid for latent tuberculosis infection in healthcare workers: a prospective study in a tertiary hospital</title><author>Chung, Sung Jun ; Lee, Hyun ; Koo, Gun Woo ; Min, Ji-Hee ; Yeo, Yoomi ; Park, Dong Won ; Park, Tai Sun ; Moon, Ji-Yong ; Kim, Sang-Heon ; Kim, Tae Hyung ; Sohn, Jang Won ; Yoon, Ho Joo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-15ca7c99ec90e5d2bc9528669f507697ced3b850c690f3683cdfd509435d2a7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>692/308/409</topic><topic>692/699/255/1856</topic><topic>Adult</topic><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Alanine Transaminase - blood</topic><topic>Antitubercular Agents - administration & dosage</topic><topic>Antitubercular Agents - adverse effects</topic><topic>Chemical and Drug Induced Liver Injury - blood</topic><topic>Chemical and Drug Induced Liver Injury - diagnosis</topic><topic>Chemical and Drug Induced Liver Injury - epidemiology</topic><topic>Chemical and Drug Induced Liver Injury - etiology</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health Personnel - statistics & numerical data</topic><topic>Hepatotoxicity</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Isoniazid</topic><topic>Isoniazid - administration & dosage</topic><topic>Isoniazid - adverse effects</topic><topic>Latent Tuberculosis - diagnosis</topic><topic>Latent Tuberculosis - drug therapy</topic><topic>Liver - drug effects</topic><topic>Liver - enzymology</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Severity of Illness Index</topic><topic>Tertiary Care Centers - 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However, the factors associated with non-completion of nine-month LTBI treatment with isoniazid (9 H) have not been well studied. We investigated the completion rate and factors affecting adherence to LTBI treatment with 9 H among HCWs. A prospective cohort study of 114 HCWs who were diagnosed with LTBI by QuantiFERON-TB Gold In-Tube tests were performed in a single university hospital between June 2016 and December 2017. All patients received the 9 H LTBI treatment. At each visit, treatment adherence and development of adverse reactions to isoniazid were evaluated via a standard questionnaire. To evaluate the impact of the severity of hepatotoxicity on non-completion of LTBI treatment, we classified hepatotoxicity into two groups: severe hepatotoxicity was defined as alanine aminotransferase >3.0 times the upper normal limit (UNL) with symptoms or = 5.0 times the UNL. Mild hepatotoxicity was defined as alanine aminotransferase>UNL, but not meet the definition of severe hepatotoxicity. Overall, 71 HCWs (62.3%) completed LTBI treatment with 9 H while 43 HCWs (37.7%) discontinued their treatment. Most discontinuation (81.4%, 35/43) occurred during the first three months of treatment. There were no significant differences in age, sex, occupation, or comorbidities between the HCWs who completed and those who discontinued LTBI treatment. However, HCWs who discontinued LTBI treatment had more hepatotoxicity than those who completed treatment (44.2% vs. 11.3%,
P
< 0.001). Cox proportional hazard analysis revealed that hepatotoxicity is the only factor significantly associated with discontinuation of 9 H LTBI treatment (unadjusted HR = 2.89, 95% CI = 1.62–5.46). In multivariable analysis, not only severe hepatotoxicity (adjusted HR = 7.99, 95% CI = 3.05–20.94) but also mild hepatotoxicity was significantly associated with discontinuation of LTBI treatment (adjusted HR = 2.34, 95% CI = 1.05–5.21). The completion rate of 9 H LTBI treatment was 62.3% among HCWs. While age, sex, occupation, and pretreatment comorbidities were not associated with treatment completion, isoniazid-induced hepatotoxicity significantly affected adherence.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32296096</pmid><doi>10.1038/s41598-020-63156-8</doi><orcidid>https://orcid.org/0000-0001-8636-446X</orcidid><orcidid>https://orcid.org/0000-0001-7132-2988</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 692/308/409 692/699/255/1856 Adult Alanine Alanine transaminase Alanine Transaminase - blood Antitubercular Agents - administration & dosage Antitubercular Agents - adverse effects Chemical and Drug Induced Liver Injury - blood Chemical and Drug Induced Liver Injury - diagnosis Chemical and Drug Induced Liver Injury - epidemiology Chemical and Drug Induced Liver Injury - etiology Drug Administration Schedule Female Follow-Up Studies Health Personnel - statistics & numerical data Hepatotoxicity Humanities and Social Sciences Humans Isoniazid Isoniazid - administration & dosage Isoniazid - adverse effects Latent Tuberculosis - diagnosis Latent Tuberculosis - drug therapy Liver - drug effects Liver - enzymology Male Medical personnel Medication Adherence - statistics & numerical data Middle Aged multidisciplinary Prospective Studies Risk Factors Science Science (multidisciplinary) Severity of Illness Index Tertiary Care Centers - statistics & numerical data Time Factors Tuberculosis |
| title | Adherence to nine-month isoniazid for latent tuberculosis infection in healthcare workers: a prospective study in a tertiary hospital |
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