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Int J Tuberc Lung Dis. 2004 Mar;8(3):333-40.

Recurrent tuberculosis in Houston, Texas: a population-based study.

Author information

1
Department of Pathology, Baylor College of Medicine, Houston, Texas 77030, USA.

Abstract

OBJECTIVE:

To determine the predictors of recurrence of tuberculosis (TB), the drug resistance pattern of Mycobacterium tuberculosis strains recovered from recurrent TB patients, and the frequency of re-infection with a new M. tuberculosis strain among patients with recurrent disease.

DESIGN:

A population-based, retrospective case-control study using the Houston Tuberculosis Initiative database.

RESULTS:

We found that, among 100 patients with recurrent TB who completed adequate therapy for a first episode of TB, not receiving directly observed therapy, pulmonary disease, HIV/AIDS diagnosis, not having a family physician, being unemployed and using public transportation were predictors of recurrent disease. There was a significant increase in drug-resistant M. tuberculosis strains in the second episode of disease compared to the first episode (21.3% vs. 8.2%, P = 0.04). Exogenous re-infection with a new strain of M. tuberculosis was found to cause 24-31% of recurrent TB.

CONCLUSION:

Recurrent TB in Houston is associated with a significant increase in drug-resistant M. tuberculosis strains. Re-infection with a new M. tuberculosis strain causes a significant proportion of recurrent TB in an area of low TB incidence. Patients with HIV/AIDS constitute a population at increased risk of disease recurrence.

PMID:
15139472
[Indexed for MEDLINE]

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