title: Risk factors for non-cure among new sputum smear positive tuberculosis patients treated in tuberculosis dispensaries in Yunnan, China.
abstract: BACKGROUND
  Yunnan province in China has a high tuberculosis (TB) burden. Cure rates in general are high, but they were below the target of 85% in 26 out of 129 counties in 2005. In these 26 counties we assessed which patient-related and treatment-related factors were associated with non-cure.
  
  
  METHODS
  We conducted a prospective cohort study. Smear positive pulmonary TB patients treated at the local Center for Disease Control and Prevention (CDC) were interviewed before start of treatment and during the fifth month of treatment using structured questionnaires. Information on treatment outcome was extracted from patient records. Patients cured at the end of treatment were compared to patients with unsuccessful treatment outcomes (failure, default, and death).
  
  
  RESULTS
  A total of 841 patients were registered between January-June 2007 of which 792 (94%) were cured. Independent risk factors for non-cure were having a low income (<3000 RMB per year), not having medical insurance, a delay in health care seeking >30 days, a positive smear test result two months after start of treatment, not being aware of the need to go to the CDC for medical follow up during treatment, and not seeing the need for treatment observation.
  
  
  CONCLUSIONS
  Reducing the financial burden of TB disease and providing health education to improve compliance with treatment could increase the proportion of patients with successful treatment outcomes.
authors.affiliation: Yunnan Provincial Centers for Disease Control and Prevention, Yunnan, China. ynhuajianzhao@hotmail.com
authors.forename: Hua
authors.initials: H
authors.lastname: Jianzhao
authors.forename: Susan
authors.initials: S
authors.lastname: van den Hof
authors.forename: Xu
authors.initials: X
authors.lastname: Lin
authors.forename: Qiu
authors.initials: Q
authors.lastname: Yubang
authors.forename: Hou
authors.initials: H
authors.lastname: Jinglong
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: van der Werf
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000191:economics / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D003153:Community Health Services; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors; D013183:Sputum / Q000737:chemistry / Q000382:microbiology*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents