Vree M, Huong N T, Duong B D, Sy D N, Van L N, Hung N V, Co N V, Borgdorff M W, Cobelens F G
KNCV Tuberculosis Foundation, 3501 CC The Hague, The Netherlands.
Int J Tuberc Lung Dis. 2007 Apr;11(4):392-7.
Reported tuberculosis (TB) cure rates are high in Vietnam with the 8-month short-course chemotherapy regimen. However, long-term treatment outcomes are unknown.
To assess survival and relapse rates among patients successfully treated for new smear-positive pulmonary tuberculosis (PTB).
A cohort of patients treated in 32 randomly selected districts in northern Vietnam were followed up 12-24 months after reported cure or treatment success for survival and bacteriologically confirmed relapse. Measurements included sputum smear examination, culture and interview for recent treatment history.
Of 304 patients included in the study, no information was available for 31 (10%) and 19 (6%) had died. Bacteriology results were available for 244 (80%). The median interval between treatment completion and follow-up was 19 months. Relapse was recorded in 21/244 (8.6%, 95%CI 5.4-13), including 9 (4%) with positive sputum smears, 3 (1%) with negative smears but positive culture and 9 (4%) who had started TB retreatment. Four of 12 culture-positive relapse cases (33%) had multidrug-resistant strains. If the definition of relapse was extended to include death, reportedly due to TB, the relapse proportion was 26/263 (9.9%, 95%CI 6.6-14).
A substantial proportion of patients (15%) had died or relapsed after being successfully treated for TB in northern Vietnam.
越南采用8个月短程化疗方案，报告的结核病治愈率很高。然而，长期治疗结果尚不清楚。
评估新涂阳肺结核患者成功治疗后的生存率和复发率。
对越南北部32个随机选取地区治疗的一组患者进行随访，在报告治愈或治疗成功后12 - 24个月，观察其生存情况及细菌学确诊的复发情况。测量包括痰涂片检查、培养以及近期治疗史访谈。
纳入研究的304例患者中，31例（10%）无信息，19例（6%）死亡。244例（80%）有细菌学结果。治疗结束至随访的中位间隔时间为19个月。244例中有21例（8.6%，95%CI 5.4 - 13）复发，包括痰涂片阳性9例（4%）、涂片阴性但培养阳性3例（1%）以及开始再次抗结核治疗9例（4%）。12例培养阳性复发病例中有4例（33%）为耐多药菌株。如果将复发定义扩展至包括据报道因结核病死亡的情况，复发比例为26/263（9.9%，95%CI 6.6 - 14）。
在越南北部，相当一部分患者（15%）在结核病成功治疗后死亡或复发。
