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Evaluation of need and feasibility of tuberculosis screening in buprenorphine treatment programs

Posted on:2012-06-13Degree:M.DType:Thesis
University:Yale UniversityCandidate:Schwarz, RyanFull Text:PDF
GTID:2464390011964737Subject:Health Sciences
Abstract/Summary:
Background. Buprenorphine's availability in primary care settings offers increased access to treatment and linkage to primary care for opioid-dependent patients. Currently, tuberculin skin testing (TST) is recommended for patients enrolling in methadone maintenance treatment (MMT), but not for those enrolling in buprenorphine maintenance treatment (BMT).;Objectives. To compare TST screening results in enrollees in BMT and MMT programs and assess the correlates of TST positivity among these subjects.;Methods. A cross-sectional analysis of a retrospective cohort study was conducted to compare concurrent TST results among contemporaneously matched groups of MMT and BMT patients in the same community.;Results. TST positivity was 9% in both MMT and BMT settings (p = .27). Increased TST positivity was associated with being Black (AOR = 3.53, CI = 1.28--9.77), Hispanic (AOR = 3.11, CI = 1.12--8.60), and having higher education (AOR = 3.01, CI = 1.20--7.53).;Conclusions. These results confirm a similarly high prevalence of TST positivity in opioid-dependent patients enrolling in MMT and BMT programs. Racial and ethnic health disparities remain associated with TST positivity, yet a relationship between higher education and tuberculosis requires further investigation.;Scientific significance. These data suggest the importance of incorporating TST screening in emerging BMT programs as a mechanism to provide increased detection and treatment of tuberculosis infection in opioid-dependent patient populations.
Keywords/Search Tags:BMT, TST positivity, Tuberculosis, Programs, Increased, Opioid-dependent, MMT, Screening
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