[Tuberculosis annual report 2008--series 10. Treatment outcome and TB deaths].

Evaluation of the outcome of treatment by the cohort analysis method is an important aspect of TB control. In the Japanese tuberculosis (TB) surveillance system, the outcome of treatment is automatically classified by computer according to the order of pre-set algorithm, so the treatment outcome is evaluated very rigidly. Although treatment outcomes are classified roughly into the eight categories of "cured", "completed", "died", "failed", "defaulted", "transferred", "still on treatment" and "not evaluated", there are actually 15 categories in our surveillance system; each category of "completed", "defaulted", and "still on treatment" has two subcategories and "not evaluated" has five subcategories. In the case of new sputum smear positive pulmonary cases (n=9,421) newly notified in 2007, their treatment outcome was as follows; "success" which combined "cured" and "completed" was 45.5%, "died" was 18.4%, "failed" was 1.0%, "defaulted" was 5.0%, "transferred" was 3.2%, "still on treatment" was 12.0% and "not evaluated" was 14.9%. Among the 5.0% who were classified as "defaulted", 0.7% was due to treatment interruption for more than consecutive 60 days or 2 months, and 4.3% was due to premature treatment cessation of any causes. The category "not evaluated" includes those who died before beginning treatment, those whose initial treatment regimen is unknown, those whose treatment is other than standard treatment, those who stopped INH and/or RFP before treatment completion, and those whose information is insufficient for classifying treatment outcome. In addition to evaluation of treatment outcome by the cohort method, the proportion of deaths was observed among all forms of TB patients (n = 25,184) and new sputum smear positive pulmonary patients (n=9421) who were newly registered in 2007. 16.4% of all forms of TB cases and 22.5% of new sputum smear positive pulmonary cases died within one year after beginning of treatment. Among new sputum smear positive pulmonary patients died within one year after beginning of treatment (n=2124), 36.2% of them died within one month after beginning of treatment, 52.4% within two months, 61.9% within three months.