2017 State and City TB Report
Completion of Therapy
Fully treating and, therefore, preventing further spread of M. tuberculosis is key to TB control and elimination. If TB drugs are stopped too soon or not taken correctly, a person may develop symptoms again or drug resistance may develop, enabling the further spread of TB. Each patient is unique. There are many reasons why a patient might be unable or unwilling to complete TB treatment such as no longer experiencing symptoms of TB, not fully understanding the treatment regimen, not being willing or able to manage side effects of their treatment regimen, cultural beliefs, language barriers, difficulty getting health care, substance use, or mental health issues. Completion of therapy among persons who have experienced homelessness or been incarcerated can be particularly challenging due to difficulty locating patients for follow up care and treatment, and is particularly important because of the risk of transmission at shelters or in the jail or prison systems. There are several ways to increase treatment completion. These include directly observed therapy (in which patients are observed to ingest each dose of anti-TB medications) and use of incentives and enablers (e.g., gift cards for food or bus fare for transportation to get to and from the health department) to get patients to complete treatment.
Table 1image iconTB treatment is complex and can take several months to complete. It can take up to 2 years to have full treatment information reported for each TB patient. As a result, the most recent information available on completion of therapy is from patients identified with TB in 2015. For these patients, 15 states met or exceeded the 2020 national target of 95.0% of TB cases completing a full treatment regimen in 12 months or less; 18 states and 3 cities were short of the 2020 target, but met or exceeded the national average (89.5%) (Figure 9image icon). Additionally, in 2015 there were 8 states and 5 cities that reported more than 7 TB patients, 15 years of age or older who were homeless in the year prior to diagnosis; 8 of these jurisdictions exceeded the national average of 84.9% completion of therapy among homeless TB patients (Table 1image icon). There were 6 states and 2 cities in 2015 that reported more than 5 TB patients, 15 years of age or older who were incarcerated at TB diagnosis; 4 of these jurisdictions exceeded the national average of 86.4% completion of therapy among incarcerated TB patients (Table 2image icon).