Treatment outcome of new pulmonary tuberculosis in Guangzhou, China 1993-2002: a register-based cohort study.
BACKGROUND
Completion of treatment for tuberculosis (TB) is of utmost priority for TB control programs. The aims of this study were to evaluate the treatment outcome of TB cases registered in Guangzhou during the period 1993-2002, and to identify factors associated with treatment success.


METHODS
Two (of eight) districts in Guangzhou were selected randomly as objects of study and their surveillance database was analyzed to assess the treatment outcome and identify factors associated with treatment success for TB cases registered in Guangzhou. Six treatment outcome criteria were assessed based on guidelines set by the World Health Organization (WHO). Logistic regression was used to estimate risk factors for treatment outcome.


RESULTS
A total of 6743 pulmonary tuberculosis cases (4903 males, 1840 females) were included in this study. The treatment success rate (including cured and complete treatment) was 88% (95%CI 87%-89%). One hundred and eight-six (2.8%) patients died and 401 (5.9%) patients defaulted treatment. In multivariate analysis, treatment success was found to be associated with young age, lack of cavitation and compliance with treatment.


CONCLUSIONS
The total treatment success rate in the current study was similar to the WHO target for all smear positive cases, while the failure rate and the default rate in 2002 were slightly higher. Good care of elderly patients, early diagnosis of cavitation and compliance with treatment could improve the success rate of TB treatment.
Bao
Qing-Song
QS
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Zhongshan Road II 74, Guangzhou, Guangdong Province, The People's Republic of China. greenpine2004@yahoo.com.cn
Du
Yu-Hua
YH
Lu
Ci-Yong
CY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D023801:Directly Observed Therapy; D004352:Drug Resistance, Microbial; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance; D011159:Population Surveillance; D012042:Registries; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control
D000995:Antitubercular Agents; D004977:Ethambutol