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Biomed Environ Sci. 2016 Aug;29(8):612-617.

Risk of Treatment Failure in Patients with Drug-susceptible Pulmonary Tuberculosis in China.

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National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Center office, Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing 101149, China; Beijing Chest Hospital, Capital Medical University, Beijing 101149, China; Clinical Center on Tuberculosis, China CDC, Beijing 101149, China.
Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
Guangzhou Chest Hospital, Guangzhou 510095, Guangdong, China.
Tianjin Centers for Disease Control and Prevention, Tianjin 300041, China.
Department of TB Control, Henan Center for Disease Control and Prevention, Zhengzhou 450016, Henan, China.
Hebei Center for Disease Control and Prevention, Shijiazhuang 050021, Hebei, China.
Department of TB Control, Guangxi Center for Disease Control and Prevention, Nanning 530021, Guangxi, China.
Chongqing Anti-tuberculosis Institute, Chongqing 400050, China.
Department of TB Control, Yunnan Center for Disease Control and Prevention, Kunming 650022, Yunnan, China.


The objective of this prospective study of the risks of treatment failure in patients with drug-susceptible pulmonary tuberculosis (PTB) was to provide reference data to help develop a disease control strategy. Participants were recruited in eight provinces of China from October 2008 to December 2010. A total of 1447 patients with drug-susceptible PTB and older than 15 years of age were enrolled. Demographic characteristics, bacteriological test results, and patient outcome, i.e., cure or treatment failure were recorded and compared using the chi-square or Fisher's exact tests. Multivariate logistic regression was used to identify factors associated with risk of treatment failure. Of the 1447 patients who were enrolled, 1349 patients (93.2%) were successfully treated and 98 (6.8%) failed treatment. Failure was significantly associated with age 365 years [odds ratio (OR)=2.522, 95% confidence interval (CI): (1.097-5.801)], retreatment [OR=2.365, 95% CI: (1.276-4.381)], missed medicine [OR=1.836, 95% CI: (1.020-3.306)], treatment not observed [OR=1.879 95% CI: (1.105-3.195)], and positive culture result after the first [OR=1.971, 95% CI: (1.080-3.597)] and second month [OR=4.659, 95% CI: (2.590-8.382)]. The risk factors associated with treatment failure were age 365 years, retreatment, missed medication, treatment not observed, and positive culture at the end of month 1 or month 2. These risk factors should be monitored during treatment and interventions carried out to reduce or prevent treatment failure and optimize treatment success.

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