1. Treatment outcomes and relapses of pulmonary tuberculosis in Lazio, Italy, 1999-2001: a six-year follow-up study
- Author
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Faustini, A., Hall, A. J., Mantovani, J., Sangalli, M., Perucci, C. A., Ciardi, M., Iaiani, G., Mastroianni, C., Mastropietro, C., Teggi, A., Cauda, R., Cingolani, A., Di Giambenedetto, S., Saltini, C., Bocchino, M., De Marco, M., Ghirba, P., Grisetti, S., Palmieri, F., Rianda, A., Traversa, M., Alma, M., Antonelli, F., Pugliesi, G., Olivieri, M., Rossi, A., Sanguinetti, M., Simeoni, I., Pandolfi, A., Bologna, E., Carrescia, M., Alimenti, P., Cantero, M., Ticca, F., Lancella, L., Dainotto, D., Geraci, S., Anzalone, E., Buratti, A. R., Zanini, R., Signore, A., Goretti, S. M., Munafo, G., Autore, F., Pitorri, A., Le Donne, R., Armignaco, A., Bernardini, G., Fiorani, C. M., Di Michele, L., De Padova, F., Manenti, M., Runci, G., Rossi, P., Aquilani, S., Cecere, R., Ercole, A., Esterini, G., Gallo, L., Gnesivo, C., Guadagnali, R., Labriola, V., Loffredo, M. R., Pasqualitto, P., Patti, P., Porcelli, P., Tanzariello, E., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Sanguinetti M. (ORCID:0000-0002-9780-7059), Faustini, A., Hall, A. J., Mantovani, J., Sangalli, M., Perucci, C. A., Ciardi, M., Iaiani, G., Mastroianni, C., Mastropietro, C., Teggi, A., Cauda, R., Cingolani, A., Di Giambenedetto, S., Saltini, C., Bocchino, M., De Marco, M., Ghirba, P., Grisetti, S., Palmieri, F., Rianda, A., Traversa, M., Alma, M., Antonelli, F., Pugliesi, G., Olivieri, M., Rossi, A., Sanguinetti, M., Simeoni, I., Pandolfi, A., Bologna, E., Carrescia, M., Alimenti, P., Cantero, M., Ticca, F., Lancella, L., Dainotto, D., Geraci, S., Anzalone, E., Buratti, A. R., Zanini, R., Signore, A., Goretti, S. M., Munafo, G., Autore, F., Pitorri, A., Le Donne, R., Armignaco, A., Bernardini, G., Fiorani, C. M., Di Michele, L., De Padova, F., Manenti, M., Runci, G., Rossi, P., Aquilani, S., Cecere, R., Ercole, A., Esterini, G., Gallo, L., Gnesivo, C., Guadagnali, R., Labriola, V., Loffredo, M. R., Pasqualitto, P., Patti, P., Porcelli, P., Tanzariello, E., Cauda R. (ORCID:0000-0002-1498-4229), Cingolani A. (ORCID:0000-0002-3793-2755), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
Objectives: The aim of this study was to enhance tuberculosis (TB) treatment outcome monitoring by linking diverse surveillance systems and estimating treatment outcomes including relapse. Methods: Tuberculosis treatment was surveyed in the Lazio region (Italy) from 1999 to 2001; a six-year follow-up of notified cases was undertaken to detect relapses. The results were analyzed as a population-based case-control study comparing each unsuccessful outcome and relapse with eligible controls. Results: Of the 974 patients who entered the survey, 805 (82.6%) had complete treatment evaluations; 398 (49.4%) had a successful outcome, 401 (49.8%) had an unsuccessful outcome, and six developed chronic TB. Death was associated with age >64 years (OR 5.9; 95% CI 3.1-11.2), male gender (OR 2.1; 95% CI 1.0-4.4), and using second-line drugs (OR 2.3; 95% CI 1.0-5.4). Treatment failure was associated with previous treatment (OR 3.0; 95% CI 1.4-6.7) and being male, being foreign born (OR 6.6; 95% CI 2.1-21.2), receiving second-line drugs (OR 7.4; 95% CI 1.8-29.5), and receiving modified therapy (OR 5.1; 95% CI 1.7-14.9). Relapses after successful outcomes were detected in 5.5%, for which the strongest predictor was having extrapulmonary lesions (OR 22.8; 95% CI 1.8-287.3). Conclusions: Linking our survey data to other surveillance systems improved the mortality estimates and detected a high rate of relapse. Having received previous treatment and being a foreigner were independent determinants of treatment failure, suggesting that both acquired and primary drug resistance affect TB patients in Lazio. © 2008 International Society for Infectious Diseases.
- Published
- 2008