Prediction of treatment failure and compliance in patients with tuberculosis
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RESEARCH ARTICLE
Open Access
Prediction of treatment failure and compliance in patients with tuberculosis Hyeon-Kyoung Koo1, Jinsoo Min2, Hyung Woo Kim3, Joosun Lee4, Ju Sang Kim3, Jae Seuk Park5 and Sung-Soon Lee1*
Abstract Background: To improve treatment outcomes for tuberculosis (TB), efforts to reduce treatment failure are necessary. The aim of our study was to describe the characteristics of subjects who had failed treatment of tuberculosis and identify the risk factors for treatment failure and poor compliance using national data. Methods: A multicenter cross-sectional study was performed on tuberculosis subjects whose final outcome was reported as treatment failure during 2015–2017. The same number of subjects with treatment success during the same study period were randomly selected for comparison. Demographics, microbiological, radiographic, and clinical data were collected based on in-depth interviews by TB nurse specialists at all Public Private Mix (PPM) participating hospitals in South Korea. Results: A total of 52 tuberculosis patients with treatment failure were enrolled. In a multivariable analysis, the presence of diabetes, previous history of tuberculosis, and cavity were identified as risk factors for treatment failure; and Medicaid support was a favorable factor for treatment success (area under the curve [AUC]: 0.79). Age, low body mass index (BMI), presence of diabetes, preexisting lung disease, positive sputum acid-fast bacilli (AFB) smear result, and the presence of multidrug-resistant tuberculosis (MDR-TB) were significantly associated with presence of cavities. Younger age, lower BMI and previous history of TB were associated with poor compliance during treatment (AUC: 0.76). Conclusion: To reduce treatment failure, careful evaluation of the presence of diabetes, previous TB history, underlying lung disease, cavity, results of sputum AFB smears, and socioeconomic status are needed. To enhance treatment compliance, more attention should be paid to younger patients with lower BMIs during follow-up. Keywords: Public-private sector partnership, Treatment failure, Tuberculosis, Korea
Background Tuberculosis (TB) remains an unsolved public health problem despite the strenuous efforts exerted by numerous countries [1]. In spite of the high economic status and medical services system, South Korea is included as an intermediate TB burden country and is in first place for TB development among the countries that are members of the * Correspondence: [email protected] 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-gu, Goyang 10380, Republic of Korea Full list of author information is available at the end of the article
Organization for Economic Co-operation and Development [2]. To overcome this situation, the Public Private Mix (PPM) collaboration model that supports diagnosis and treatment of TB has been implemented as a national TB control strategy, and as a consequence, th
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