Acceptability of Long Acting Injectables for Tuberculosis Preventative Treatment Among High Risk Persons in Tbilisi, Georgia Restricted; Files Only

Abstract

Purpose: A key component of the World Health Organization’s End Tuberculosis (TB) strategy by 2030 is to rapidly increase the uptake of TB preventive treatment (TPT). A major challenge in the acceptance of TPT is achieving sustained adherence to oral treatment regimens of 1-6 months duration among asymptomatic individuals. Long-acting injectable (LAI) agents for latent TB treatment are under development and show promise as clinical trials are ongoing. This study assessed the acceptability and feasibility of hypothetical LAI use for TPT among household and close contacts of active TB cases and those considered at high-risk of developing TB.

 

Methods: A cross-sectional survey was conducted at the National Center for TB and Lung Diseases (NCTLD) in Tbilisi, Georgia in May-July 2024. Eligible participants included adults who were household or close contacts of active TB cases in addition to high-risk groups as outlined by the WHO (e.g., persons living with HIV). The survey assessed participants' knowledge of TB and TPT treatment options, current use of oral medications, and existing health conditions. The survey explored the perceived ease of LAI adherence and whether healthcare professionals would influence their LAI use. The primary focus of the survey was to evaluate participants' willingness to use LAI versus daily oral regimens for TPT.

 

Results: A total of 66 participants completed the survey. Overall, 27% of participants indicated they would use LAI, 42% were unsure, and 30% indicated they would not. A low number of participants (21%) agreed to take oral TPT. The majority (74%) of participants indicated they would be willing to try LAIs if they only had to receive one injection. Participants identified perceived benefits as reduced pill burden (86%) and increased convenience (76%) as advantages of LAIs while reporting side effects (91%) and lack of efficacy (89%) as perceived risks.

Conclusions: Our survey found that the largest proportion of participants (42%) were unsure about their acceptance of LAIs, highlighting a substantial need for education and outreach prior to future LAI implementation. Overall, the results indicate a preference for a single-dose LAI option, suggesting that minimizing the number of injections may help optimize the future implementation of LAI preventive treatments.

Table of Contents

Introduction

Methods

Results

Discussion

Conclusion

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Parola chiave	Long Acting Injectable Tuberculosis Epidemiology Long Acting injections Tuberculosis Preventative Treatment cross-sectional LAIs
Committee Chair / Thesis Advisor	Matthew Magee, Emory University Russell Kempker, Emory University

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