title: Morbidity and mortality at five years after initiating Category I treatment among patients with new sputum smear positive pulmonary tuberculosis.
abstract: BACKGROUND
  Evaluation of disease outcome is central to the assessment of tuberculosis control programmes. Most of the follow up studies in RNTCP are short-term. Five year follow up studies have not been done previously in this region. The objective of the present study is to [corrected] evaluate the outcome of Category I treatment in smear positive tuberculosis, five years after treatment in terms of relapse, sequelae and death and to know the associated factors.
  
  
  METHODS
  Patients who had registered for Category 1 treatment during the period 2002 - 2004 were followed up at five years with clinical evaluation, Chest X-ray, ESR and sputum AFB smear.
  
  
  RESULTS
  Of the 224 patients who were studied, 81% patients were males. Addictions, including smoking and alcoholism, were prevalent in 136 patients (61%). Treatment success rate at six months was 94.2%. At the end of five years, 124 patients (57.9%) were symptomatic, 59% patients had radiological sequelae, relapse in 10 patients (4.5%), and mortality in 12 (5.4%) patients. Diabetes mellitus was the most common comorbid illness. Smoking and age > or = 45 years were associated with radiological sequelae. Smoking was significantly associated with mortality. Smokers had worse outcomes in all parameters.
  
  
  CONCLUSIONS
  Relapse rate was 4.5% and overall mortality was 5.4% at the end of five years. Significant proportion of patients has radiological sequelae. Smoking was the preventable risk factor associated with sequelae, relapse and mortality.
authors: Institute of Chest Diseases, Government Medical College, Kozhikode, Kerala.
authors: P V
authors: PV
authors: Lisha
authors: P T
authors: PT
authors: James
authors: C
authors: C
authors: Ravindran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality*; D055815:Young Adult