Predictors of pulmonary tuberculosis treatment outcomes in South Korea: A prospective cohort study, 2005-2012

Hongjo Choi, Myungsun Lee, Ray Y. Chen, Youngran Kim, Soyoung Yoon, Joon S. Joh, Seung K. Park, Lori E. Dodd, Jongseok Lee, Taeksun Song, Ying Cai, Lisa C. Goldfeder, Laura E. Via, Matthew W. Carroll, Clifton E. Barry, Sangnae Cho

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Abstract

Background: Tuberculosis remains an important health concern in many countries. The aim of this study was to identify predictors of unfavorable outcomes at the end of treatment (EOT) and at the end of study (EOS; 40 months after EOT) in South Korea.Methods: New or previously treated tuberculosis patients were recruited into a prospective observational cohort study at two hospitals in South Korea. To identify predictors of unfavorable outcomes at EOT and EOS, logistic regression analysis was performed.Results: The proportion of multidrug-resistant tuberculosis (MDR-TB) was 8.2% in new cases and 57.9% in previously treated cases. Of new cases, 68.6% were cured, as were 40.7% of previously treated cases. At EOT, diabetes, ≥3 previous TB episodes, ≥1 significant regimen change, and MDR-TB were significantly associated with treatment failure or death. At EOS, age ≥35, body-mass index (BMI) <18.5, diabetes, and MDR-TB were significantly associated with treatment failure, death, or relapse. Among cases that were cured at EOT, age ≥50 and a BMI <18.5 were associated with subsequent death or relapse during follow-up to EOS. Treatment interruption was associated with service sector employees or laborers, bilateral lesions on chest X-ray, and previous treatment failure or treatment interruption history.Conclusions: Risk factors for poor treatment outcomes at EOT and EOS include both patient factors (diabetes status, age, BMI) and disease factors (history of multiple previous treatment episodes, MDR-TB). In this longitudinal, observational cohort study, diabetes mellitus and MDR-TB were risk factors for poor treatment outcomes and relapse. Measures to help ensure that the first tuberculosis treatment episode is also the last one may improve treatment outcomes.Trial registration: ClinicalTrials.gov ID: NCT00341601.

Original languageEnglish
Article number360
JournalBMC Infectious Diseases
Volume14
Issue number1
DOIs
Publication statusPublished - 2014 Jul 2

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Republic of Korea
Pulmonary Tuberculosis
Cohort Studies
Prospective Studies
Multidrug-Resistant Tuberculosis
Treatment Failure
Therapeutics
Tuberculosis
Body Mass Index
Recurrence
Observational Studies
Diabetes Mellitus
Thorax
Logistic Models
History
Regression Analysis
X-Rays

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

Cite this

Choi, Hongjo ; Lee, Myungsun ; Chen, Ray Y. ; Kim, Youngran ; Yoon, Soyoung ; Joh, Joon S. ; Park, Seung K. ; Dodd, Lori E. ; Lee, Jongseok ; Song, Taeksun ; Cai, Ying ; Goldfeder, Lisa C. ; Via, Laura E. ; Carroll, Matthew W. ; Barry, Clifton E. ; Cho, Sangnae. / Predictors of pulmonary tuberculosis treatment outcomes in South Korea : A prospective cohort study, 2005-2012. In: BMC Infectious Diseases. 2014 ; Vol. 14, No. 1.
@article{80f64034ce834fab878fbe02546b832c,
title = "Predictors of pulmonary tuberculosis treatment outcomes in South Korea: A prospective cohort study, 2005-2012",
abstract = "Background: Tuberculosis remains an important health concern in many countries. The aim of this study was to identify predictors of unfavorable outcomes at the end of treatment (EOT) and at the end of study (EOS; 40 months after EOT) in South Korea.Methods: New or previously treated tuberculosis patients were recruited into a prospective observational cohort study at two hospitals in South Korea. To identify predictors of unfavorable outcomes at EOT and EOS, logistic regression analysis was performed.Results: The proportion of multidrug-resistant tuberculosis (MDR-TB) was 8.2{\%} in new cases and 57.9{\%} in previously treated cases. Of new cases, 68.6{\%} were cured, as were 40.7{\%} of previously treated cases. At EOT, diabetes, ≥3 previous TB episodes, ≥1 significant regimen change, and MDR-TB were significantly associated with treatment failure or death. At EOS, age ≥35, body-mass index (BMI) <18.5, diabetes, and MDR-TB were significantly associated with treatment failure, death, or relapse. Among cases that were cured at EOT, age ≥50 and a BMI <18.5 were associated with subsequent death or relapse during follow-up to EOS. Treatment interruption was associated with service sector employees or laborers, bilateral lesions on chest X-ray, and previous treatment failure or treatment interruption history.Conclusions: Risk factors for poor treatment outcomes at EOT and EOS include both patient factors (diabetes status, age, BMI) and disease factors (history of multiple previous treatment episodes, MDR-TB). In this longitudinal, observational cohort study, diabetes mellitus and MDR-TB were risk factors for poor treatment outcomes and relapse. Measures to help ensure that the first tuberculosis treatment episode is also the last one may improve treatment outcomes.Trial registration: ClinicalTrials.gov ID: NCT00341601.",
author = "Hongjo Choi and Myungsun Lee and Chen, {Ray Y.} and Youngran Kim and Soyoung Yoon and Joh, {Joon S.} and Park, {Seung K.} and Dodd, {Lori E.} and Jongseok Lee and Taeksun Song and Ying Cai and Goldfeder, {Lisa C.} and Via, {Laura E.} and Carroll, {Matthew W.} and Barry, {Clifton E.} and Sangnae Cho",
year = "2014",
month = "7",
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doi = "10.1186/1471-2334-14-360",
language = "English",
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Choi, H, Lee, M, Chen, RY, Kim, Y, Yoon, S, Joh, JS, Park, SK, Dodd, LE, Lee, J, Song, T, Cai, Y, Goldfeder, LC, Via, LE, Carroll, MW, Barry, CE & Cho, S 2014, 'Predictors of pulmonary tuberculosis treatment outcomes in South Korea: A prospective cohort study, 2005-2012', BMC Infectious Diseases, vol. 14, no. 1, 360. https://doi.org/10.1186/1471-2334-14-360

Predictors of pulmonary tuberculosis treatment outcomes in South Korea : A prospective cohort study, 2005-2012. / Choi, Hongjo; Lee, Myungsun; Chen, Ray Y.; Kim, Youngran; Yoon, Soyoung; Joh, Joon S.; Park, Seung K.; Dodd, Lori E.; Lee, Jongseok; Song, Taeksun; Cai, Ying; Goldfeder, Lisa C.; Via, Laura E.; Carroll, Matthew W.; Barry, Clifton E.; Cho, Sangnae.

In: BMC Infectious Diseases, Vol. 14, No. 1, 360, 02.07.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of pulmonary tuberculosis treatment outcomes in South Korea

T2 - A prospective cohort study, 2005-2012

AU - Choi, Hongjo

AU - Lee, Myungsun

AU - Chen, Ray Y.

AU - Kim, Youngran

AU - Yoon, Soyoung

AU - Joh, Joon S.

AU - Park, Seung K.

AU - Dodd, Lori E.

AU - Lee, Jongseok

AU - Song, Taeksun

AU - Cai, Ying

AU - Goldfeder, Lisa C.

AU - Via, Laura E.

AU - Carroll, Matthew W.

AU - Barry, Clifton E.

AU - Cho, Sangnae

PY - 2014/7/2

Y1 - 2014/7/2

N2 - Background: Tuberculosis remains an important health concern in many countries. The aim of this study was to identify predictors of unfavorable outcomes at the end of treatment (EOT) and at the end of study (EOS; 40 months after EOT) in South Korea.Methods: New or previously treated tuberculosis patients were recruited into a prospective observational cohort study at two hospitals in South Korea. To identify predictors of unfavorable outcomes at EOT and EOS, logistic regression analysis was performed.Results: The proportion of multidrug-resistant tuberculosis (MDR-TB) was 8.2% in new cases and 57.9% in previously treated cases. Of new cases, 68.6% were cured, as were 40.7% of previously treated cases. At EOT, diabetes, ≥3 previous TB episodes, ≥1 significant regimen change, and MDR-TB were significantly associated with treatment failure or death. At EOS, age ≥35, body-mass index (BMI) <18.5, diabetes, and MDR-TB were significantly associated with treatment failure, death, or relapse. Among cases that were cured at EOT, age ≥50 and a BMI <18.5 were associated with subsequent death or relapse during follow-up to EOS. Treatment interruption was associated with service sector employees or laborers, bilateral lesions on chest X-ray, and previous treatment failure or treatment interruption history.Conclusions: Risk factors for poor treatment outcomes at EOT and EOS include both patient factors (diabetes status, age, BMI) and disease factors (history of multiple previous treatment episodes, MDR-TB). In this longitudinal, observational cohort study, diabetes mellitus and MDR-TB were risk factors for poor treatment outcomes and relapse. Measures to help ensure that the first tuberculosis treatment episode is also the last one may improve treatment outcomes.Trial registration: ClinicalTrials.gov ID: NCT00341601.

AB - Background: Tuberculosis remains an important health concern in many countries. The aim of this study was to identify predictors of unfavorable outcomes at the end of treatment (EOT) and at the end of study (EOS; 40 months after EOT) in South Korea.Methods: New or previously treated tuberculosis patients were recruited into a prospective observational cohort study at two hospitals in South Korea. To identify predictors of unfavorable outcomes at EOT and EOS, logistic regression analysis was performed.Results: The proportion of multidrug-resistant tuberculosis (MDR-TB) was 8.2% in new cases and 57.9% in previously treated cases. Of new cases, 68.6% were cured, as were 40.7% of previously treated cases. At EOT, diabetes, ≥3 previous TB episodes, ≥1 significant regimen change, and MDR-TB were significantly associated with treatment failure or death. At EOS, age ≥35, body-mass index (BMI) <18.5, diabetes, and MDR-TB were significantly associated with treatment failure, death, or relapse. Among cases that were cured at EOT, age ≥50 and a BMI <18.5 were associated with subsequent death or relapse during follow-up to EOS. Treatment interruption was associated with service sector employees or laborers, bilateral lesions on chest X-ray, and previous treatment failure or treatment interruption history.Conclusions: Risk factors for poor treatment outcomes at EOT and EOS include both patient factors (diabetes status, age, BMI) and disease factors (history of multiple previous treatment episodes, MDR-TB). In this longitudinal, observational cohort study, diabetes mellitus and MDR-TB were risk factors for poor treatment outcomes and relapse. Measures to help ensure that the first tuberculosis treatment episode is also the last one may improve treatment outcomes.Trial registration: ClinicalTrials.gov ID: NCT00341601.

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U2 - 10.1186/1471-2334-14-360

DO - 10.1186/1471-2334-14-360

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