Lee Jen-Jyh, Wu Rong-Lun, Lee Yeong-Sheng, Wu Yi-Chun, Chiang Chen-Yuan
Division of Chest Medicine, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan.
J Formos Med Assoc. 2007 Jan;106(1):25-30. doi: 10.1016/S0929-6646(09)60212-6.
BACKGROUND/PURPOSE: The World Health Organization (WHO) has proposed that treatment outcome is an important indicator of tuberculosis control. This study investigated the outcome of tuberculosis treatment at a medical center in eastern Taiwan.
A total of 166 pulmonary tuberculosis patients notified by Tzu Chi Hospital in 2002 were included in this study. Treatment outcome data were collected at the local level and categorized according to WHO recommendations as cured, treatment completed, failed, died, defaulted, or transferred. Outcomes of the 166 patients, as reported by the National Tuberculosis Program were obtained from the Taiwan Center for Disease Control (Taiwan CDC) for comparison.
Of the 166 patients, outcome was classified as cured in 46 (27.7%), treatment completed in 73 (44.0%), died in 27 (16.3%), treatment failed in five (3.0%), and defaulted in 15 (9.0%). Males were more likely to die or to default than females, and the elderly were more likely to die than younger patients. Patients with comorbidities were significantly more likely to die than patients without (p = 0.025). Patients with a history of tuberculosis were more likely to default (p = 0.050). Smear-positive patients were more likely to fail, and patients without cavitation on chest radiograph were more likely to have successful treatment. Outcomes of 26 (15.7%) cases in this cohort were unavailable (18 cases) or inaccurate (8 cases) on the Taiwan CDC website.
The unsatisfactory outcome of pulmonary tuberculosis treatment in this medical center in eastern Taiwan highlights the importance of implementing directly observed treatment short course strategy. Improvement in the quality of data reported by the National Tuberculosis Program is urgently needed.
背景/目的：世界卫生组织（WHO）提出治疗结果是结核病控制的一项重要指标。本研究调查了台湾东部某医疗中心的结核病治疗结果。
本研究纳入了2002年慈济医院通报的166例肺结核患者。在地方层面收集治疗结果数据，并根据WHO的建议分类为治愈、完成治疗、治疗失败、死亡、失访或转出。由台湾疾病控制中心（台湾CDC）提供国家结核病防治计划报告的这166例患者的治疗结果，以便进行比较。
166例患者中，46例（27.7%）治疗结果分类为治愈，73例（44.0%）完成治疗，27例（16.3%）死亡，5例（3.0%）治疗失败，15例（9.0%）失访。男性比女性更易死亡或失访，老年人比年轻患者更易死亡。有合并症的患者比无合并症的患者死亡可能性显著更高（p = 0.025）。有结核病病史的患者更易失访（p = 0.050）。涂片阳性患者更易治疗失败，胸部X线片无空洞的患者治疗更易成功。该队列中26例（15.7%）病例在台湾CDC网站上的结果不可用（18例）或不准确（8例）。
台湾东部该医疗中心肺结核治疗结果不理想，凸显了实施直接督导下的短程治疗策略的重要性。迫切需要提高国家结核病防治计划报告数据的质量。
