title: A retrospective case-control study, factors affecting treatment outcomes for pulmonary tuberculosis in istanbul, Turkey.
abstract: BACKGROUND
  Tuberculosis is a public health problem and its transmission is a threat to the community.
  
  
  OBJECTIVE
  The aim of this study was to determine the factors influencing the treatment outcomes and the effectiveness of the National Tuberculosis Program (NTP) in relation to the application of the directly observed treatment, short-course (DOTS) program in various sites in Istanbul, Turkey.
  
  
  METHODS
  Case-Control Study.
  
  
  METHODS
  A case-control study was used, where cases and controls were randomly selected from the Turkish Tuberculosis National Database, which includes complete data on treatment outcomes for patients recorded in the database from January 1, 2006 to December 31, 2009 and had one year follow-up.
  
  
  RESULTS
  The case group was composed of 464 patients with adverse outcome, while the control group was composed of 441 patients who had been cured of disease. Factors associated with adverse treatment outcome were >65 years of age (OR: 3.39 (1.99-5.76)) ; male gender (OR:2.11 (1.49-2.99)); born outside Turkey (OR: 5.48 (2.13-14.04)); co-morbidity (OR: 1.85 (1.29-2.65)); bilateral radiologic lesions (OR: 2.07 (1.41-3.00); previous treatment history (OR: 3.99 (2.78-5.74)); 3(rd) month positive microscopy (OR: 4.96 (3.04-8.09)) and any H&R +/- others multidrug resistant (MDR) resistance (OR: 22.64 (6.92-74.08)). There was no association between the adverse treatment outcome and the application site of direct observation treatment, short course (DOTS) delivery and the supervisors.
  
  
  CONCLUSIONS
  Our findings indicate similar quality in DOTS application and supervision among patients with or without adverse treatment outcomes. However, patients with certain characteristics should be carefully monitored and aggressively treated.
authors.affiliation: Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Babalık
authors.affiliation: Department of Pulmonology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Zeki
authors.initials: Z
authors.lastname: Kılıçaslan
authors.affiliation: Department of Pulmonology, Kadıköy Tuberculosis Dispensary, İstanbul, Turkey.
authors.forename: Sule
authors.initials: S
authors.lastname: Kızıltaş
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Gencer
authors.affiliation: Department of Pulmonology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey, Department of Pulmonology, İstanbul, Turkey.
authors.forename: Gül
authors.initials: G
authors.lastname: Ongen
keywords: Tuberculosis; affecting factors; treatment outcome