Is quarterly cohort analysis useful for assessing treatment outcomes in a low incidence country?
Abstract:SETTING: In the Czech Republic, a country regarded as having a low incidence of tuberculosis (TB), short-course chemotherapy (SCC) of TB has been implemented in routine practice country-wide.
OBJECTIVE: To assess the outcome of SCC by quarterly cohort analysis of patients using the methodology recommended by the World Health Organization (WHO).
DESIGN: Patients with newly detected bacteriologically confirmed pulmonary TB notified in 1998 were treated according to local recommendations (SCC) or with the WHO-recommended DOTS strategy. The type of chemotherapy and its outcome were evaluated 12 months later by quarterly cohort analysis.
RESULTS: A total of 731 patients with bacteriologically confirmed pulmonary TB, 403 of them smear-positive, were assessed. The proportion of those treated under the DOTS strategy increased from 56.2% to 75.1%. Favourable treatment outcomes (cure or treatment completed) were achieved in 69.0% of patients in the first quarter and 74.0% in the fourth quarter. Only four treatment failures and 21 defaulters were recorded. A total of 129 patients (15–21% in different cohorts) died before or during treatment, mostly from causes not connected with TB. If this proportion were not taken into account, treatment efficacy would have attained 85%.
CONCLUSIONS: Analysis of SCC based on quarterly cohorts proved feasible in routine conditions in a country with a low incidence of TB and ongoing TB control, and provided more information than once yearly analysis.
Document Type: Regular Paper
Affiliations: National Tuberculosis Surveillance Unit, Department of Pneumology & Thoracic Surgery, Faculty Hospital Bulovka, Prague, Czech Republic
Publication date: March 1, 2001
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