Free Content Management and treatment outcomes of tuberculous patients, eastern Paris, France, 2004

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Abstract:

BACKGROUND: France was one of the few European countries without a national tuberculosis (TB) treatment outcome monitoring system until 2007.

OBJECTIVE: To examine TB management and treatment outcomes in the eastern Paris region, and to identify patient- and management-dependent factors affecting treatment outcome.

METHODS: This retrospective study focused on all cases of microbiologically confirmed Mycobacterium tuberculosis cases diagnosed in 2004 in the eastern Paris region, one of the areas of France with the highest frequency of TB.

RESULTS: Treatment outcomes of 629 identified cases (males 69.6%, median age 37 years, socio-economically disadvantaged 44%, foreign-born 78%) were as follows: treatment success 70.1% (95%CI 66.5–73.7), treatment interruption 4.9% (95%CI 3.2–6.6), loss to follow-up 15.0% (95%CI 12.2–17.8), death 5.7% (95%CI 3.9–7.9), transfers 4.3% (95%CI 3.5–5.1). Non-completion of treatment was associated with sputum smear positivity, injection drug use, non-adherence and irregular follow-up in univariate analysis, and with irregular follow-up and non-adherence in multivariate analysis. Duration of TB treatment and follow-up medical visits were not applied as recommended in more than a third of cases.

CONCLUSION: The treatment success rate observed in this study (70.1%) is below the World Health Organization target of 85%, and requires the implementation and evaluation of interventions to increase treatment success rates.

Keywords: health system; management; treatment outcome; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Service de Maladies Infectieuses et Tropicales, Assistance publique des Hôpitaux de Paris (APHP), Hôpital Saint-Antoine, Paris, France 2: U707, Faculté de médecine Saint Antoine, Institut national de la Santé et de la Recherche médicale, Paris, France; and UMR S 707, Université Pierre et Marie Curie, Université Paris 06, Paris, France 3: U707, Faculté de médecine Saint Antoine, Institut national de la Santé et de la Recherche médicale, Paris, France 4: Cellule Tuberculose, Direction de l'Action Sociale de l'Enfance et de la Santé, Paris, France 5: Institut de Veille Sanitaire, Saint-Maurice, France 6: U707, Faculté de médecine Saint Antoine, Institut national de la Santé et de la Recherche médicale, Paris, France; and Service de Pneumologie, APHP, Hôpital Saint-Antoine, Paris, France

Publication date: July 1, 2009

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  • 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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