Tuberculosis in European cities: establishment of a patient monitoring system over 10 years in Paris, France.
BACKGROUND
Tuberculosis (TB) is a persistent public health problem in European cities. France has been unable to report on treatment outcomes until now, and it is not known whether the World Health Organization (WHO) target cure rate of 85% has been met.


METHODS
All patients placed under treatment in four hospitals and five out-patient Social Medical Centres in Paris were followed up between 1996 and 2005. Patient monitoring and evaluation were performed using a new software programme, TB-INFO.


RESULTS
In a cohort of 1127 patients, 76% had pulmonary TB, of whom 39% were smear-positive, 81% were foreign-born and 9.3% were human immunodeficiency virus positive. At the end of the follow-up, 16% were cured and 54% had completed treatment. Among the 1118 non-multidrug-resistant patients, these percentages were 17% and 46%, respectively, for smear-positive pulmonary patients. Some patients died (1.9%) or failed treatment (0.1%), but many more defaulted (20.5%) as they interrupted treatment (1.5%), were lost to follow-up (19.5%) or were transferred out (7.9%).


CONCLUSIONS
This 10-year follow-up of TB patients, managed with TB-INFO software, shows that a patient monitoring system can be implemented in France, providing essential information. Treatment success in this cohort of patients was far below the WHO target.
Farge
D
D
Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-Louis, Paris, France. dominique.farge-bancel@sls.aphp.fr
Porcher
R
R
Antoun
F
F
Fain
O
O
Keshtmand
H
H
Rocher
G
G
Mallet
H-P
HP
Rambeloarisoa
J
J
Gerber
F
F
De Castro
N
N
Che
D
D
Coulombier
D
D
Zaleskis
R
R
Herrmann
J-L
JL
Dye
C
C
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D000328:Adult; D000554:Ambulatory Care Facilities; D000995:Antitubercular Agents / Q000627:therapeutic use; D016208:Databases, Factual; D054242:Emigrants and Immigrants; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010297:Paris / Q000453:epidemiology; D010349:Patient Compliance; D011159:Population Surveillance / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents