[Outcome of treating initial tuberculosis in the area south of Seville in a 5-year period (1994-1998].
OBJECTIVE
To analyze the outcome of treating initial tuberculosis (ITB) in the hospital district south of Seville (Spain).


METHODS
A descriptive study of treatment outcome in cases of ITB in our district between 1 January 1994 and 31 December 1998. Outcome was classified according to World Health Organization guidelines:successful (S) potentially unsuccessful (PU), exitus (EX) and transferred out (T).Four hundred fifty-four patients (mean age 35 years) were enrolled; 22% were HIV+ and 21% were intravenous drug users (IVDU). Treatment was self-administered in all cases, with 98% being given the standard prescription of 6 or 9 drugs. No subsequent case history was found for 15 cases, such that outcome could not be assessed.


RESULTS
Of the 439 evaluable cases, outcome was S for 74% (326/439), PU for 16% (70/439), EX for 8% (36/439) and T for 6. Outcome for HIV + patients was poorer than for HIV- patients (S: 35/98 versus 291/341, p < 0.00005;PU: 40/98 versus 30/341, p < 0.00005), and the mortality rate of HIV+ patients was higher than that of HIV- patients (EX:18/98 versus 18/341, p < 0.0008). Among those classified PU,no cases of treatment failure were recorded and up to 78% (31/40)were cases of loss of follow-up or abandonment. The variable most closely related to PU was IVDU status (OR = 10.5, p < 0.00005).


CONCLUSIONS
a) Outcomes for the general population are acceptable. b)A marginal group has been identified as characterized by two variables, HIV+ and IVDU, which are the factors associated with poorer outcome of self-administered treatment, indicating that supervised treatment is advisable in cases where those factors are present.
Campos Rodríguez
F
F
Neumología. Hospital Universitario de Valme. Sevilla.
Muñoz Lucena
F
F
Umbría Domínguez
S
S
Méndez
C
C
Nogales Pérez
M
M
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000401:mortality
D000995:Antitubercular Agents