Tuberculosis outcomes in Taipei: factors associated with treatment interruption for 2 months and death

SETTING: All individuals reported as being treated for pulmonary tuberculosis (PTB) among citizens of Taipei City, Taiwan, in 2003.OBJECTIVES: To investigate risk factors associated with treatment interruption for at least 2 consecutive months and death.DESIGN: The outcome of PTB cases was determined by consulting medical charts.RESULTS: Of 1127 PTB patients registered, 824 (73.1%) were successfully treated, 189 (16.8%) died, 65 (5.8%) interrupted treatment, 17 (1.5%) were still on treatment 15 months after commencing treatment and 32 (2.8%) failed. The only significant factor associated with treatment interruption was visits to other health facilities after commencing tuberculosis (TB) treatment. TB patients had a standardised mortality ratio of 8.7 (95%CI 7.5-10.0). Factors significantly associated with death were age (adjusted hazard ratio [adjHR] 1.06. 95%CI 1.05-1.08), sputum culture not performed/unknown (adjHR 2.07, 95%CI 1.47-2.92), and comorbidity with respiratory disease (adjHR 1.68, 95%CI 1.24-2.27), infectious disease (adjHR 2.80, 95%CI 2.07-3.78), renal disease (adjHR 2.58, 95%CI 1.82-3.66) or cancer (adjHR 3.31, 95%CI 2.35-4.65), compared with other patients.CONCLUSION: Visits to other health facilities were associated with interruption of treatment for at least 2 months. A high proportion of deaths was due to old age and comorbidity.