In Arkansas, the case rate of tuberculosis (TB) among Hispanics is higher than it is for non-Hispanics even though the state’s overall TB case rate has trended down dramatically for many years. How much this higher TB incidence among Hispanics may be related to the increasing influx of Latin American immigrants from countries with higher TB burdens is unclear, particularly since many of these are unauthorized immigrants who tend to avoid medical care. Unfortunately, tuberculosis treatment regimens are complex and lengthy, yet successful completion of TB chemotherapy treatment remains an important factor in managing the control of TB. A review of the literature indicated that Hispanic ethnicity, male gender and elderly age were among the risk factors of the disease in Arkansas, making treatment completion among these at-risk population segments a high priority in avoiding an upturn in TB incidence.
The purpose of this quantitative study was to investigate the relationship between Hispanics and non-Hispanics in Arkansas with regard to TB treatment completion while considering the effects of age and sex. A 1993 to 2013 TB surveillance dataset was obtained from the Arkansas Department of Health (ADH) and subjected to a retrospective audit using a descriptive, exploratory approach based on post-positivist methodology.
The study sample consisted of 2,280 cases of active TB, of which 221 were Hispanic and 2,059 were non-Hispanic. Hispanic cases were found to lag behind non-Hispanic cases with 74% completing treatment and 26% failing to complete treatment, which compared to non-Hispanics’ 81% completion and 19% non-completion rates. Pearson’s chi-square analysis showed a statistically significant difference (p = .016) in regard to ethnicity with Hispanics tending to complete treatment less frequently than non-Hispanics, though no significant effect from age or sex was noted. Spatial analysis of the dataset indicated that the majority of incomplete treatment cases for Hispanics tended to occur in northwest Arkansas.
This research study provided insight into the difference in TB treatment completion between Hispanics and non-Hispanics in Arkansas. With Hispanic immigration projected to increase, these results have implications for practice and policy in regard to the management and control of tuberculosis.
|Advisor:||Schmidt, Cheryl K.|
|Commitee:||Bates, Joseph, Kennedy, Robert, Tsai, Pao-Feng, Wright, Patricia|
|School:||University of Arkansas for Medical Sciences|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 77/01(E), Dissertation Abstracts International|
|Subjects:||Geographic information science, Epidemiology|
|Keywords:||Geographic information systems, Gis, Hispanics, Tb treatment, Tuberculosis|
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