Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Lucian Davis


Background: Latent tuberculosis infections affect around two billion people world-wide. In order to effectively control and reduce TB incidence, latent TB cases must be identified and treated. The latent TB cascade of care involves screening, diagnosis, evaluation, prescription of a treatment regimen, and completion of treatment. Existing studies have identified low rates of LTBI treatment completion among patients in diverse settings.

Objective: The aim of this study was to assess certain steps in the cascade of care among the LTBI-positive patients referred to the Winchester Chest Clinic in order to determine where patients were lost to follow up and potential inequities in care between patient groups.

Methods: This was a retrospective cohort study performed through medical chart data review for LTBI-positive Winchester patients. The presence of a chest x-ray, medication prescription, at least one follow-up appointment and at least four follow-up appointments were used to assess patient completion of the evaluation and treatment stages of care. Multivariate models were created using demographic variables classifying gender, race, ethnicity and age as the independent variables, and the outcome variables as the dependent variable.

Results: Female patients had lower odds of being prescribed medications and completing at least one follow-up appointment than did their male counterparts (OR 0.4 and OR 0.3, respectively). Non-Hispanic or Latino patients were more likely than Hispanic or Latino patients to be prescribed TB medications or complete at least one follow-up appointment (OR 1.6 and OR 1.8, respectively). Black patients were also less likely to complete a follow-up appointment than non-black patients (OR 0.5), and Asian patients were less likely to be prescribed medications than non-Asian patients (OR 0.5).


This is an Open Access Thesis.

Open Access

This Article is Open Access