The implementation of rifapentine and isoniazid (3HP) in two remote Arctic communities with a predominantly Inuit population, the Taima TB 3HP study

Background: The incidence of TB among Inuit is the highest in Canada. A significantly shorter latent TB infection (LTBI) treatment with rifapentine and isoniazid once weekly for 12 weeks (3HP) is now available in limited settings in Canada. Methods: A prospective open-label 2-year observational post...

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Bibliographic Details
Published in:International Journal of Circumpolar Health
Main Authors: G. G. Alvarez, D. Van Dyk, R. Mallick, S. Lesperance, P. Demaio, S. Finn, S. Edmunds Potvin, M. Patterson, C. Pease, K. Amaratunga, C. Hui, D.W. Cameron, S. Mulpuru, S.D. Aaron, F. Momoli, A. Zwerling
Format: Article in Journal/Newspaper
Language:English
Published: Taylor & Francis Group 2020
Subjects:
inuit
tuberculosis
latent tuberculosis infection treatment
Arctic medicine. Tropical medicine
RC955-962
Arctic
Nunavut
Canada
Qikiqtarjuaq
Circumpolar Health
International Journal of Circumpolar Health
Iqaluit
Online Access:https://doi.org/10.1080/22423982.2020.1758501
https://doaj.org/article/16425fe448d14bd6920642445f46808f
Description
Summary:Background: The incidence of TB among Inuit is the highest in Canada. A significantly shorter latent TB infection (LTBI) treatment with rifapentine and isoniazid once weekly for 12 weeks (3HP) is now available in limited settings in Canada. Methods: A prospective open-label 2-year observational postmarketing study was conducted introducing 3HP for the first time in Canada in Iqaluit followed by a program rollout in Qikiqtarjuaq, Nunavut. Results: A total of 247 people were offered 3HP, 102 in the Iqaluit postmarketing study and 145 in the Qikiqtarjuaq program roll out. Although statistical significance was not reached, more people who started treatment completed treatment in the 3HP group (Iqaluit, 60/73 (82.2%) and Qikiqtarjuaq, 89/115 (77.4%)) than in the historical control 9INHgroup (306/420 = 72.9%) (p = 0.2). Most of the adverse events in 3HP treated patients were associated with mild discomfort but no disruption of normal daily activity. Not drinking alcohol was associated with increased 3HP completion (OR 13.33, 95% CI, 2.27–78.20) as was not taking concomitant medications (OR 7.19, 95% CI, 1.47–35.30). Conclusions: The present study supports the feasibility and safety profile of 3HP for the treatment of LTBI in Nunavut.

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