Free Content Tuberculosis in European cities: establishment of a patient monitoring system over 10 years in Paris, France

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Abstract:

BACKGROUND: Tuberculosis (TB) is a persistent public health problem in European cities. France has been unable to report on treatment outcomes until now, and it is not known whether the World Health Organization (WHO) target cure rate of 85% has been met.

METHODS: All patients placed under treatment in four hospitals and five out-patient Social Medical Centres in Paris were followed up between 1996 and 2005. Patient monitoring and evaluation were performed using a new software programme, TB-INFO.

RESULTS: In a cohort of 1127 patients, 76% had pulmonary TB, of whom 39% were smear-positive, 81% were foreign-born and 9.3% were human immunodeficiency virus positive. At the end of the follow-up, 16% were cured and 54% had completed treatment. Among the 1118 non-multidrug-resistant patients, these percentages were 17% and 46%, respectively, for smear-positive pulmonary patients. Some patients died (1.9%) or failed treatment (0.1%), but many more defaulted (20.5%) as they interrupted treatment (1.5%), were lost to follow-up (19.5%) or were transferred out (7.9%).

CONCLUSIONS: This 10-year follow-up of TB patients, managed with TB-INFO software, shows that a patient monitoring system can be implemented in France, providing essential information. Treatment success in this cohort of patients was far below the WHO target.

Keywords: TB-INFO software; WHO target; patient cohort monitoring; treatment outcomes

Document Type: Regular Paper

Affiliations: 1: Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-Louis, Paris, France 2: Département de Biostatistique et Informatique Médicale, Hôpital Saint-Louis, Paris, France 3: Cellule Tuberculose, Direction de l'Action Sociale de l'Enfance et de la Santé, Paris, France 4: Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France 5: Centre Hospitalier de Carnelle, Saint Martin du Tertre, France 6: Service de Pneumologie, Hôpital Saint-Louis, Paris, France 7: Service de Maladies Infectieuses, Hôpital Saint-Louis, Paris, France 8: Institut National de Veille Sanitaire, Saint-Maurice, France 9: European Centre for Disease Prevention and Control, Stockholm, Sweden 10: World Health Organization Regional Office for Europe, Copenhagen, Denmark 11: Service de Microbiologie, Hôpital Raymond Poincaré, Garches, France 12: Stop TB Department, World Health Organization, Geneva, Switzerland 13: URL: http://www.tb-info.org

Publication date: September 1, 2007

More about this publication?
  • 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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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