title: An investigation into the relationship between region specific quality of life and adverse tuberculosis treatment outcomes in Istanbul, Turkey.
abstract: OBJECTIVE
  Istanbul has the highest incidence of tuberculosis (TB) in Turkey. It is also the largest city, with considerable differences in quality of life across its urban regions. The aim of this study is to investigate the relationship between (i) the diverse quality of life across specific urban regions, (ii) TB incidence rates, inclusive of demographic and clinical characteristics of TB patients, and (iii) adverse treatment outcomes.
  
  
  METHODS
  This retrospective study included 23,845 new TB patients (recorded in the National TB Registry between 2006 and 2010) in Istanbul. Thirty-nine urban districts of Istanbul were ranked into five groups on the basis of an urban quality of life index. Patient data were matched with these groups, and further categorized according to 'age', 'sex', 'country of birth' and 'antibiotics resistance'. Adverse treatment outcomes and TB incidence rates were extracted from official records. Logistic regression, clustered analyses, 95% CI and p values (STATA) were reported to describe the association between variables.
  
  
  RESULTS
  Six per cent of total cases had 'at least one adverse treatment outcome' (default 3.8%, failure 0.5%, death 1.7% in total cases). 'An adverse treatment outcome' was found to be associated with age OR (CI 95%) (1.02 (1.01-1.03)); 'male sex' 1.65 (1.28-2.12); 'other country of birth' 4.82 (3.05-7.62); 100,000 per 'over 60' insidence goups 1.61 (1.32-1.97), the lowest quality of life index 0.65 (0.47-0.83).
  
  
  CONCLUSIONS
  Patients with high tuberculosis risk factors living in high incidence regions need to be closely monitored. Patients living in lower ranking regions are more likely to have 'poor treatment outcomes'.
authors.affiliation: Department of Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Electronic address: aylinbabalik@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Babalik
authors.affiliation: Kadıkoy Tuberculosis Dispensary, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Kiziltas
authors.affiliation: Clinic of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Gencer
authors.affiliation: Department of Pulmonology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Kilicaslan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010349:Patient Compliance; D011788:Quality of Life; D012189:Retrospective Studies; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D014421:Turkey; D055815:Young Adult
keywords: Adverse outcome; Fatores de risco da tuberculose; Incidência da tuberculose; Qualidade de vida urbana; Resultado adverso; Tuberculose; Tuberculosis; Tuberculosis incidence; Tuberculosis risk factors; Urban quality of life