1. Recurrent pulmonary tuberculosis after treatment success: a population-based retrospective study in China.
- Author
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Ruan, Qiao-ling, Yang, Qing-luan, Sun, Feng, Liu, Wei, Shen, Yao-jie, Wu, Jing, Jiang, Ning, Zhou, Jing-yu, Shao, Ling-yun, and Zhang, Wen-hong
- Subjects
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TUBERCULOSIS , *DIRECTLY observed therapy , *PANEL analysis , *TREATMENT effectiveness - Abstract
Post-treatment recurrence remains a challenge for the global control of tuberculosis (TB). This study investigated longitudinal data on pulmonary TB recurrence rates and risk factors for recurrence among successfully treated smear-positive tuberculosis cases in China. Between 1st January 2009 and 31st December 2016 we evaluated 33 441 treatment-naïve patients diagnosed with sputum-smear-positive, non-multidrug-resistant TB in Hangzhou, China. We included the data of 9828 patients with TB who were treated successfully. A total of 4.9% of the cases were recurrent (479/9828), identified within a median observation period lasting 1565 days. Altogether, 51.1% (245/479) of the recurrences occurred within 1 year. The cumulative 2- and 5-year recurrence rates were 3.90% (95% confidence interval (CI) 3.3–4.5%) and 5.4% (95%CI 4.8–6.0%), respectively. Prolonged treatment (over 7 months) occurred in 64.7% (6363/9828), with a median treatment duration of 242 days (interquartile range 195–348 days). Male sex (adjusted hazard ratio (aHR) (95%CI) 1.61 (1.30–2.00), p < 0.001), age 60 years old or older (aHR (95%CI) 2.03 (1.70–2.44), p < 0.001), pulmonary cavity (aHR (95%CI) 1.51 (1.25–1.82), p < 0.001) and sputum positivity at 2 months (aHR (95%CI) 1.39 (1.05–1.81), p 0.02) all increased the risk of TB recurrence. Prolonged treatment was associated with reduced TB recurrence (aHR (95%CI) 0.73 (0.61–0.88), p 0.001). Recurrence remains a problem for successfully treated patients with sputum-smear-positive pulmonary TB, especially those with independent risk factors. Further analysis of prolonged treatment is required. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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