Point-of-care Arkansas method for measuring adherence to treatment with isoniazid

Guerra, Renata L.; Conde, Marcus B.; Efron, Anne; Loredo, Carla; Bastos, Gisele; Chaisson, Richard E.; Golub, Jonathan E.

doi:10.1016/j.rmed.2010.02.001

« Previous Next »Respiratory Medicine
Volume 104, Issue 5 , Pages 754-757, May 2010

Point-of-care Arkansas method for measuring adherence to treatment with isoniazid

Renata L. Guerra
- Institute of Thoracic Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Corresponding author. Tuberculosis Clinical Research Laboratory, Institute of Thoracic Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, No. 255, 6° andar, Cidade Universitária, Rio de Janeiro, RJ CEP: 21941-913, Brazil. Tel.: +55 21 2562 2432; fax: +55 21 2562 2853.
Marcus B. Conde
- Institute of Thoracic Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Anne Efron
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
Carla Loredo
- Institute of Thoracic Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Gisele Bastos
- Institute of Thoracic Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Richard E. Chaisson
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
Jonathan E. Golub
- Johns Hopkins University School of Medicine, Baltimore, MD, USA

Received 2 September 2009; accepted 1 February 2010. published online 04 March 2010.

Summary

We evaluated the accuracy of a point-of-care test designed to measure adherence to isoniazid (INH) preventive therapy in a hospital setting in Rio de Janeiro, Brazil. Patients on treatment with daily INH and patients not receiving INH were included. Sensitivity and specificity of the test were 84%/98% at the first minute, and 95%/98% at the fifth minute, respectively. Among smokers, sensitivity and specificity was reduced (80%/89% at the fifth minute, respectively), but only 17% smoked. This test accurately detected INH metabolites 24h following directly observed INH intake, though sensitivity and specificity may be compromised by tobacco smoke exposure.