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Open Access Risk factors for unfavourable treatment outcome among new smear-positive pulmonary tuberculosis cases in China

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Setting: Three projects of the Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB.

Objectives: To assess unfavourable treatment outcomes (UTOs), including failure, died, loss to follow-up (LTFU), transferred out and unknown outcome, and to identify risk factors associated with UTOs.

Design: This was a cross-sectional study using routine programme data.

Results: Of 30 277 new smear-positive tuberculosis (TB) patients, 4261 (14.1%) had UTOs: 2048 (6.8%) LTFU, 1418 (4.7%) transferred out, 390 (1.3%) died, 340 (1.1%) failed and 65 (0.2%) had an unknown outcome. Risk factors for LTFU (including LTFU, transfer out and unknown outcome) were residing in Anhui, age > 55 years, service delay > 10 days, patient delay < 30 days, directly observed treatment (DOT) provided by a family member or others and unknown DOT provider. The outcome of ‘died’ was associated with residing in Shaanxi, age > 55 years, male sex, patient delay > 30 days and unknown DOT provider. ‘Failed’ was associated with having unlimited access to health services, patient delay of >30 days and unknown DOT provider.

Conclusion: This study highlights the predominance of lost patients among UTOs. Patients with family members or other non-medical DOT providers or unknown DOT providers had a high risk of a UTO. There is an urgent need to address these service-related factors.
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Keywords: China; risk factor; tuberculosis; unfavourable outcome

Document Type: Research Article

Affiliations: 1: International Union Against Tuberculosis and Lung Disease (The Union), Beijing, China, The Union, Paris, France 2: The Union, Paris, France 3: Beijing Chest Hospital, Capital Medical University, Beijing, China, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China

Publication date: December 21, 2017

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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