Treatment outcome of Singapore residents with pulmonary tuberculosis in the first year after introduction of a computerised treatment surveillance module.
BACKGROUND
A key intervention of the Singapore Tuberculosis Elimination Programme (STEP) was the introduction in 2001 of a computerised treatment surveillance module (TSM) for the real-time monitoring of the treatment progress of the country's notified tuberculosis (TB) cases until a final outcome. We report the treatment outcome as at December 31, 2002 for the cohort of Singapore residents with new and relapsed pulmonary TB in whom treatment was commenced in 2001.


METHODS
Each TB notification will activate the TSM, which requires a return on the patient's treatment progress, treatment delivery mode and the treating physician's management decision at each clinic visit to the STEP Registry until an outcome is reached.


RESULTS
There were 1,354 Singapore residents with new or relapsed pulmonary TB who started treatment in 2001. Of these, 620 (45.8 percent) underwent directly-observed therapy (DOT) at their nearest polyclinic. As at December 31, 2002 , 79 percent of patients completed treatment, nine percent died (two percent from TB), nine percent interrupted treatment (they were either lost to follow-up or refused treatment), 1.8 percent were still on treatment, 0.6 percent left the country, and 0.5 percent had permanent cessation of treatment due to drug reactions. Factors associated with treatment completion were Chinese ethnicity (odds-ratio [OR] 1.5, 95 percent confidence interval [Cl] 1.1-2, p-value is 0.02), age younger than 65 years (OR 1.8, 95 percent Cl 1.3-3.0, p-value is 0.003) and the use of DOT (OR 3.1, 95 percent Cl 2.3-4.1, p-value is less than 0.05).


CONCLUSIONS
The findings from the TSM's first year provide a baseline for future programme evaluation.
Chee
C B E
CB
Tuberculosis Control Unit and Department of Respiratory Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. cynthia_chee@ttsh.com.sg
Wang
Y T
YT
Teleman
M D
MD
Boudville
I C
IC
Chew
S K
SK
D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003199:Computer Systems; D023801:Directly Observed Therapy / Q000706:statistics & numerical data*; D018563:Disease Notification / Q000331:legislation & jurisprudence; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D010349:Patient Compliance; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology
D000995:Antitubercular Agents