Management and treatment outcomes of tuberculous patients, eastern Paris, France, 2004.
BACKGROUND
France was one of the few European countries without a national tuberculosis (TB) treatment outcome monitoring system until 2007.


OBJECTIVE
To examine TB management and treatment outcomes in the eastern Paris region, and to identify patient- and management-dependent factors affecting treatment outcome.


METHODS
This retrospective study focused on all cases of microbiologically confirmed Mycobacterium tuberculosis cases diagnosed in 2004 in the eastern Paris region, one of the areas of France with the highest frequency of TB.


RESULTS
Treatment outcomes of 629 identified cases (males 69.6%, median age 37 years, socio-economically disadvantaged 44%, foreign-born 78%) were as follows: treatment success 70.1% (95%CI 66.5-73.7), treatment interruption 4.9% (95%CI 3.2-6.6), loss to follow-up 15.0% (95%CI 12.2-17.8), death 5.7% (95%CI 3.9-7.9), transfers 4.3% (95%CI 3.5-5.1). Non-completion of treatment was associated with sputum smear positivity, injection drug use, non-adherence and irregular follow-up in univariate analysis, and with irregular follow-up and non-adherence in multivariate analysis. Duration of TB treatment and follow-up medical visits were not applied as recommended in more than a third of cases.


CONCLUSIONS
The treatment success rate observed in this study (70.1%) is below the World Health Organization target of 85%, and requires the implementation and evaluation of interventions to increase treatment success rates.
Valin
Nadia
N
Service de Maladies Infectieuses et Tropicales, Assistance publique des Hôpitaux de Paris (APHP), Hôpital Saint-Antoine, Paris, France. nadia.valin@sat.aphp.fr
Hejblum
G
G
Borget
I
I
Mallet
H P
HP
Antoun
F
F
Che
D
D
Chouaid
C
C
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010297:Paris / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology*
D000995:Antitubercular Agents