Comparison of characteristics and mortality in multidrug resistant (MDR) and non-MDR tuberculosis patients in China

BMC Public Health

Research Article

David Harley¹  Yanni Sun¹  Adrian Sleigh¹  Hassan Vally² 

[1] National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, 2601, Canberra, Australia;School of Psychology and Public Health, La Trobe University, 3086, Melbourne, Australia;

关键词: Henan Province;    Global Fund;    Annual Household Income;    Village Doctor;    National Tuberculosis Control Program;   

DOI  :  10.1186/s12889-015-2327-8

 received in 2015-05-11, accepted in 2015-09-22,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundWe conducted a cohort study to compare the characteristics of MDR-TB with non-MDR-TB patients and to measure long term (9-year) mortality rate and determine factors associated with death in China.MethodsWe reviewed the medical records of 250 TB cases from a 2001 survey to compare 100 MDR-TB patients with 150 non-MDR-TB patients who were treated in 2001-2002. Baseline attributes extracted from the records were compared between the two cohorts and long-term mortality and risk factors were determined at nine-year follow-up in 2010.ResultsAmong the 234 patients successfully followed up, 63 (26.9%) were female and 171 (73.1 %) were male. MDR-TB patients had poorer socioeconomic status compared to non-MDRTB. Nine years after the diagnosis of TB, 69 or 29.5 % of the 234 patients had died (32 or 21.6 % of non-MDR-TB versus 37 or 43.0 % of MDR-TB) and the overall mortality rate was 39/1000 per year (PY) (27/1000 PY among non-MDR versus 63/1000 PY among MDR-TB). Factors associated with death included: MDR status (hazard ratio (HR): 1.86; CI: 1.09-3.13), limited education of primary school or lower (HR: 2.51; CI 1.34-4.70) and received TB treatment during the nine-year period (HR 1.82; 95 % CI 1.02-3.26).ConclusionsMDR-TB was a strong predictor for poor long-term outcome. High quality diagnosis and treatment must be ensured. Greater reimbursement or free treatment may be needed to provide access for the poor and vulnerable populations, and to increase treatment compliance.

【 授权许可】

CC BY   
© Sun et al. 2015