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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

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

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Yanni Sun, David Harley, Hassan Vally, Adrian Sleigh
Wichtige Hinweise

Competing interests

The authors declare that no competing interests apply.

Authors’ contribution

SYN prepared this manuscript with inputs from each listed author. Computational work, analysis of results and derivation of conclusions was conducted by SYN with input from AS, DH, and HV. All authors have read and approved the final version of the manuscript.

Authors’ information

Not applicable

Abstract

Background

We 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.

Methods

We 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.

Results

Among 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).

Conclusions

MDR-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.
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