Current status of treatment completion and fatality among tuberculosis patients in Spain

OBJECTIVES: To determine treatment completion among patients with tuberculosis (TB), and to analyse factors associated with treatment default and fatality.METHODS: A prospective cohort study of patients who began treatment between 1 June 1999 and 31 May 2000 in areas where members of the SEPAR Tuber...

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Veröffentlicht in:The international journal of tuberculosis and lung disease 2004-04, Vol.8 (4), p.458-464
Hauptverfasser: Caylà, Caminero, Rey, Lara, Vallés, Galdós-Tangüis
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container_end_page 464
container_issue 4
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container_title The international journal of tuberculosis and lung disease
container_volume 8
creator Caylà
Caminero
Rey
Lara
Vallés
Galdós-Tangüis
description OBJECTIVES: To determine treatment completion among patients with tuberculosis (TB), and to analyse factors associated with treatment default and fatality.METHODS: A prospective cohort study of patients who began treatment between 1 June 1999 and 31 May 2000 in areas where members of the SEPAR Tuberculosis and Respiratory Infections Group work. Factors associated with treatment default and fatality were studied using logistic regression, calculating odds ratios (OR) and their 95% confidence intervals (95%CI).RESULTS: The study involved 142 physicians from 76 different hospitals who provided information on 1515 cases. Eighty-two per cent of the patients completed treatment correctly, 14% defaulted, 5% died, 0.5% failed, and 8.7% interrupted treatment due to transfer or other reasons. The variables associated with default were intravenous drug use (IVDU) (OR 6.00, 95%CI 2.59-13.89) and immigration (OR 8.57, 95%CI 3.78-19.45); sex, age, homelessness, incarceration, directly observed treatment (DOT) or hospitalisation were not associated with default. Variables found to be predictive of fatality were alcoholism (OR 6.38, 95%CI 2.09-19.48), human immunodeficiency virus (HIV) infection (OR 7.08, 95%CI 2.08-29.15) and age >64 years (OR 10, 95%CI 2.9-34.07), whereas sex, IVDU, homelessness, DOT and hospitalisation were not.CONCLUSIONS: In industrialised countries, IVDU patients and immigrants should be targeted for DOT, while to reduce fatality rates stricter monitoring is required for patients who are alcoholic, HIV-infected, or aged >64 years.
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Factors associated with treatment default and fatality were studied using logistic regression, calculating odds ratios (OR) and their 95% confidence intervals (95%CI).RESULTS: The study involved 142 physicians from 76 different hospitals who provided information on 1515 cases. Eighty-two per cent of the patients completed treatment correctly, 14% defaulted, 5% died, 0.5% failed, and 8.7% interrupted treatment due to transfer or other reasons. The variables associated with default were intravenous drug use (IVDU) (OR 6.00, 95%CI 2.59-13.89) and immigration (OR 8.57, 95%CI 3.78-19.45); sex, age, homelessness, incarceration, directly observed treatment (DOT) or hospitalisation were not associated with default. Variables found to be predictive of fatality were alcoholism (OR 6.38, 95%CI 2.09-19.48), human immunodeficiency virus (HIV) infection (OR 7.08, 95%CI 2.08-29.15) and age &gt;64 years (OR 10, 95%CI 2.9-34.07), whereas sex, IVDU, homelessness, DOT and hospitalisation were not.CONCLUSIONS: In industrialised countries, IVDU patients and immigrants should be targeted for DOT, while to reduce fatality rates stricter monitoring is required for patients who are alcoholic, HIV-infected, or aged &gt;64 years.</description><identifier>ISSN: 1027-3719</identifier><identifier>EISSN: 1815-7920</identifier><identifier>PMID: 15141739</identifier><language>eng</language><publisher>Paris, France: IUATLD</publisher><subject>Adolescent ; Adult ; Antitubercular Agents - therapeutic use ; Bacterial diseases ; Biological and medical sciences ; Case-Fatality Ratio ; Cohort Studies ; Completion ; Cure ; Female ; Human bacterial diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Predictors ; Prospective Studies ; Spain ; Treatment ; Treatment Outcome ; Tuberculosis ; Tuberculosis - drug therapy ; Tuberculosis - mortality ; Tuberculosis and atypical mycobacterial infections</subject><ispartof>The international journal of tuberculosis and lung disease, 2004-04, Vol.8 (4), p.458-464</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=15766888$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15141739$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caylà</creatorcontrib><creatorcontrib>Caminero</creatorcontrib><creatorcontrib>Rey</creatorcontrib><creatorcontrib>Lara</creatorcontrib><creatorcontrib>Vallés</creatorcontrib><creatorcontrib>Galdós-Tangüis</creatorcontrib><creatorcontrib>Working Group on Completion of Tuberculosis Treatment in Spain</creatorcontrib><title>Current status of treatment completion and fatality among tuberculosis patients in Spain</title><title>The international journal of tuberculosis and lung disease</title><addtitle>Int J Tuberc Lung Dis</addtitle><description>OBJECTIVES: To determine treatment completion among patients with tuberculosis (TB), and to analyse factors associated with treatment default and fatality.METHODS: A prospective cohort study of patients who began treatment between 1 June 1999 and 31 May 2000 in areas where members of the SEPAR Tuberculosis and Respiratory Infections Group work. Factors associated with treatment default and fatality were studied using logistic regression, calculating odds ratios (OR) and their 95% confidence intervals (95%CI).RESULTS: The study involved 142 physicians from 76 different hospitals who provided information on 1515 cases. Eighty-two per cent of the patients completed treatment correctly, 14% defaulted, 5% died, 0.5% failed, and 8.7% interrupted treatment due to transfer or other reasons. The variables associated with default were intravenous drug use (IVDU) (OR 6.00, 95%CI 2.59-13.89) and immigration (OR 8.57, 95%CI 3.78-19.45); sex, age, homelessness, incarceration, directly observed treatment (DOT) or hospitalisation were not associated with default. Variables found to be predictive of fatality were alcoholism (OR 6.38, 95%CI 2.09-19.48), human immunodeficiency virus (HIV) infection (OR 7.08, 95%CI 2.08-29.15) and age &gt;64 years (OR 10, 95%CI 2.9-34.07), whereas sex, IVDU, homelessness, DOT and hospitalisation were not.CONCLUSIONS: In industrialised countries, IVDU patients and immigrants should be targeted for DOT, while to reduce fatality rates stricter monitoring is required for patients who are alcoholic, HIV-infected, or aged &gt;64 years.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Case-Fatality Ratio</subject><subject>Cohort Studies</subject><subject>Completion</subject><subject>Cure</subject><subject>Female</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Predictors</subject><subject>Prospective Studies</subject><subject>Spain</subject><subject>Treatment</subject><subject>Treatment Outcome</subject><subject>Tuberculosis</subject><subject>Tuberculosis - drug therapy</subject><subject>Tuberculosis - mortality</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><issn>1027-3719</issn><issn>1815-7920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUlLBDEQhRtR3P-C5KK3hiS9ZY4yriAoqOAtVGcZMqTTbRZBf71pZga8mEOqCF8e71XtFceEkabsFhTv5x7Trqw6sjgqTkJYY0wJId1hcUQaUpOuWhwXH8vkvXIRhQgxBTRqFL2COMxvYhwmq6IZHQInkYYI1sRvBMPoViimXnmR7BhMQBNEk78EZBx6ncC4s-JAgw3qfFtPi_e727flQ_n0fP-4vH4qTTYWy0ZpoWUvoG8Uo7qSNelJLXVPKEjQwGirGlAUV7rrBW6VbASmrFVMaL3AtDotrja6kx8_kwqRDyYIZS04NabAc3qKm5Zk8GILpn5Qkk_eDOC_-W4WGbjcAhAEWO3BCRP-cF3bMsYyd7PhjFvlyMDXY_IuZ-QmQbSSm_V8U4xrjjeH7Zqag4-5ktn4y38yYqc0L3DeH_9irs6KlGBGm9lyx6XSkGzkETxf_fCQJX8BTTOccA</recordid><startdate>20040401</startdate><enddate>20040401</enddate><creator>Caylà</creator><creator>Caminero</creator><creator>Rey</creator><creator>Lara</creator><creator>Vallés</creator><creator>Galdós-Tangüis</creator><general>IUATLD</general><general>Union internationale contre la tuberculose et les maladies respiratoires</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20040401</creationdate><title>Current status of treatment completion and fatality among tuberculosis patients in Spain</title><author>Caylà ; Caminero ; Rey ; Lara ; Vallés ; Galdós-Tangüis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i371t-5efcfdbcab5e82f3d41b14dfb12adafa826e5ae203f7bc06ed5c0286e8cff9023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Case-Fatality Ratio</topic><topic>Cohort Studies</topic><topic>Completion</topic><topic>Cure</topic><topic>Female</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Predictors</topic><topic>Prospective Studies</topic><topic>Spain</topic><topic>Treatment</topic><topic>Treatment Outcome</topic><topic>Tuberculosis</topic><topic>Tuberculosis - drug therapy</topic><topic>Tuberculosis - mortality</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Caylà</creatorcontrib><creatorcontrib>Caminero</creatorcontrib><creatorcontrib>Rey</creatorcontrib><creatorcontrib>Lara</creatorcontrib><creatorcontrib>Vallés</creatorcontrib><creatorcontrib>Galdós-Tangüis</creatorcontrib><creatorcontrib>Working Group on Completion of Tuberculosis Treatment in Spain</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of tuberculosis and lung disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Caylà</au><au>Caminero</au><au>Rey</au><au>Lara</au><au>Vallés</au><au>Galdós-Tangüis</au><aucorp>Working Group on Completion of Tuberculosis Treatment in Spain</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Current status of treatment completion and fatality among tuberculosis patients in Spain</atitle><jtitle>The international journal of tuberculosis and lung disease</jtitle><addtitle>Int J Tuberc Lung Dis</addtitle><date>2004-04-01</date><risdate>2004</risdate><volume>8</volume><issue>4</issue><spage>458</spage><epage>464</epage><pages>458-464</pages><issn>1027-3719</issn><eissn>1815-7920</eissn><abstract>OBJECTIVES: To determine treatment completion among patients with tuberculosis (TB), and to analyse factors associated with treatment default and fatality.METHODS: A prospective cohort study of patients who began treatment between 1 June 1999 and 31 May 2000 in areas where members of the SEPAR Tuberculosis and Respiratory Infections Group work. Factors associated with treatment default and fatality were studied using logistic regression, calculating odds ratios (OR) and their 95% confidence intervals (95%CI).RESULTS: The study involved 142 physicians from 76 different hospitals who provided information on 1515 cases. Eighty-two per cent of the patients completed treatment correctly, 14% defaulted, 5% died, 0.5% failed, and 8.7% interrupted treatment due to transfer or other reasons. The variables associated with default were intravenous drug use (IVDU) (OR 6.00, 95%CI 2.59-13.89) and immigration (OR 8.57, 95%CI 3.78-19.45); sex, age, homelessness, incarceration, directly observed treatment (DOT) or hospitalisation were not associated with default. 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ispartof The international journal of tuberculosis and lung disease, 2004-04, Vol.8 (4), p.458-464
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1815-7920
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subjects Adolescent
Adult
Antitubercular Agents - therapeutic use
Bacterial diseases
Biological and medical sciences
Case-Fatality Ratio
Cohort Studies
Completion
Cure
Female
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Predictors
Prospective Studies
Spain
Treatment
Treatment Outcome
Tuberculosis
Tuberculosis - drug therapy
Tuberculosis - mortality
Tuberculosis and atypical mycobacterial infections
title Current status of treatment completion and fatality among tuberculosis patients in Spain
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