Centre for International Health, University of Bergen, Overlege Danielsens Hus, Arstadveien 21, 5009 Bergen, Norway.
BMC Public Health. 2009 Sep 18;9:348. doi: 10.1186/1471-2458-9-348.
Decentralization of DOTS has increased the number of cured smear-positive tuberculosis (TB) patients. However, the rate of recurrence has increased mainly due to HIV infection. Recurrence rate could be taken as an important measure of long-term success of TB treatment. We aimed to find out the rate of recurrence in smear-positive patients cured under DOTS in southern Ethiopia.
We did a retrospective cohort study on cured smear-positive TB patients who were treated from 1998 to 2006. Recurrence of smear-positive TB was used as an outcome measure. Person-years of observation (PYO) were calculated per 100 PYO from the date of cure to date of interview. Kaplan-Meier and Cox-regression methods were used to determine the survival and the hazard ratio (HR).
368 cured smear-positive TB patients which were followed for 1463 person-years. Of these, 187 patients (50.8%) were men, 277 patients (75.5%) were married, 157 (44.2%) were illiterate, and 152 patients (41.3%) were farmers. 15 of 368 smear-positive patients had recurrence. The rate of recurrence was 1 per 100 PYO (0.01 per annum). Recurrence was not associated with age, sex, occupation, marital status and level of education.
High recurrence rate occurred among smear-positive patients cured under DOTS. Further studies are required to identify factors contributing to high recurrence rates to improve disease free survival of TB patients after treatment.
DOTS 的去中心化增加了治愈的涂阳肺结核（TB）患者数量。然而，复发率的增加主要是由于 HIV 感染。复发率可作为结核病治疗长期成功的重要衡量标准。我们旨在了解在埃塞俄比亚南部 DOTS 下治愈的涂阳患者的复发率。
我们对 1998 年至 2006 年期间接受治疗的治愈的涂阳 TB 患者进行了回顾性队列研究。涂阳 TB 的复发作为结局指标。观察的人年数（PYO）是根据治愈日期至访谈日期计算的每 100 PYO 计算的。Kaplan-Meier 和 Cox 回归方法用于确定生存率和风险比（HR）。
368 例治愈的涂阳 TB 患者随访了 1463 人年。其中，187 例（50.8%）为男性，277 例（75.5%）已婚，157 例（44.2%）为文盲，152 例（41.3%）为农民。368 例涂阳患者中有 15 例复发。复发率为每 100 PYO1 例（每年 0.01 例）。复发与年龄、性别、职业、婚姻状况和教育程度无关。
在 DOTS 下治愈的涂阳患者中复发率较高。需要进一步研究以确定导致高复发率的因素，以提高 TB 患者治疗后的无病生存率。
