Exploring the determinants of treatment success for tuberculosis cases in Europe
OBJECTIVE: To analyse the determinants of TB treatment success in different countries using individual data.
DESIGN: We asked 18 European countries with both outcome data and individual TB records to code outcomes for cases notified in 2000 and/or 2001. Cases completing treatment regardless of bacteriological proof of cure were considered successful.
RESULTS: Ten European Union countries and Iceland, Norway and Romania participated (72% response). Among 24660 TB cases (Romania excluded), ‘success’ was reported in 69% (country range 60–88%), 9% (0–11%) died, 1% (0–5%) failed, 4% defaulted or transferred (2–15%) and 12% (0–23%) were ‘unknown’. On logistic regression among cases with drug susceptibility results (n = 10303), ‘success’ was associated with younger age (>74 years: reference; 55–74 years: OR = 2.0, 95%CI 1.8–2.4; 35–54 years: 3.0, 95%CI 2.6–3.5; 15–34 years: 3.7, 95%CI 3.2–4.4; <15 years: 4.4, 95%CI 2.9–6.7), female sex (1.4, 95%CI 1.3–1.6), and no polyresistance (9.2, 95%CI 6.8–12.4). The Netherlands (1.6, 95%CI 1.3–2.0) and Slovakia (1.8, 95%CI 1.4–2.2) had higher success than Estonia (reference: lowest percentage success), while Austria was lower (0.64, 95%CI 0.52–0.78).
CONCLUSION: Preventing drug resistance, increasing adherence and improving care in the elderly should be priorities. Inter-country variations in treatment success suggest differences in the completeness of monitoring data and in the efficacy of national control programmes.
Document Type: Regular Paper
Publication date: 2005-11-01
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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