Risk factors associated with unsuccessful tuberculosis treatment outcomes in Hunan Province, China

Beth Gilmour*, Zuhui Xu, Liqiong Bai, Kefyalew Addis Alene, Archie C.A. Clements

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)
4 Downloads (Pure)

Abstract

Objectives
Globally, China has the third highest number of tuberculosis (TB) cases despite high rates (85.6%) of effective treatment coverage. Identifying risk factors associated with unsuccessful treatment outcomes is an important component of maximising the efficacy of TB control programmes.
Methods
Retrospective cohort study to evaluate the outcomes of 306,860 drug-susceptible TB patients who underwent treatment in Hunan Province, China between 2013 and 2018. Univariable and multivariable logistic regression models were used to identify factors associated with unsuccessful TB treatment outcomes.
Results
A successful treatment outcome was recorded for 98.6% of patients, defined as the sum of patients who were cured (36.2%) and completed treatment (62.4%). An unsuccessful treatment outcome was recorded for 1.8% of patients, defined as the sum of treatment failure (1.1%), deaths (0.5%) and lost to follow up (0.2%). The odds of an unsuccessful treatment outcome showed an increasing trend in more recent years of registration (2018 adjusted odds ratio (AOR): 1.43; 95% Confidence Interval (CI) 1.31, 1.57 relative to 2013). Other significant risk factors were male sex (AOR: 1.17; 95% CI 1.10, 1.25); increasing age (AOR:1.02 per year increase; 95% CI 1.02,1.02); being severely ill (AOR: 1.50; 95% CI 1.33, 1.70); having a history of TB treatment (AOR: 2.93; 95% CI 2.69, 3.20); not being under systematic management (AOR: 16.10 (14.49, 17.88) and treatment regimens that differed from full course management.
Conclusions
The increasing likelihood of an unsuccessful treatment outcome over time necessitates the need for further research.
Original languageEnglish
Pages (from-to)290-299
Number of pages10
JournalTropical Medicine and International Health
Volume27
Issue number3
Early online date11 Jan 2022
DOIs
Publication statusPublished - Mar 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Keywords

  • China
  • risk factors
  • treatment outcome
  • tuberculosis

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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