Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.
BMC Infect Dis. 2022 Jul 22;22(1):638. doi: 10.1186/s12879-022-07622-w.
Recurrence continues to place significant burden on patients and tuberculosis programmes worldwide, and previous studies have rarely provided analysis in negative recurrence cases. We characterized the epidemiological features of recurrent pulmonary tuberculosis (PTB) patients, estimated its probability associated with different bacteriology results and risk factors.
Using 2005-2018 provincial surveillance data from Henan, China, where the permanent population approximately were 100 million, we described the epidemiological and bacteriological features of recurrent PTB. The Kaplan-Meier method and Cox proportional hazard models, respectively, were used to estimate probability of recurrent PTB and risk factors.
A total of 7143 (1.5%) PTB patients had recurrence, and of 21.1% were bacteriological positive on both laboratory tests (positive-positive), and of 34.9% were negative-negative. Compared with bacteriological negative recurrent PTB at first episodes, the bacteriological positive cases were more male (81.70% vs 72.79%; P < 0.001), higher mortality risk (1.78% vs 0.92%; P = 0.003), lower proportion of cured or completed treatment (82.81% vs 84.97%; P = 0.022), and longer time from onset to end-of-treatment. The probability of recurrence was higher in bacteriological positive cases than those in bacteriological negative cases (0.5% vs 0.4% at 20 months; P < 0.05).
Based on patient's epidemiological characteristics and bacteriological type, it was necessary to actively enact measures to control their recurrent.
复发继续给全球的患者和结核病规划带来巨大负担，以前的研究很少对阴性复发病例进行分析。我们描述了复发性肺结核（PTB）患者的流行病学特征，估计了其与不同细菌学结果和危险因素相关的概率。
利用 2005-2018 年中国河南省的省级监测数据，该省的常住人口约为 1 亿，我们描述了复发性 PTB 的流行病学和细菌学特征。分别使用 Kaplan-Meier 方法和 Cox 比例风险模型估计复发性 PTB 的概率和危险因素。
共有 7143 例（1.5%）PTB 患者复发，其中 21.1%的患者两次实验室检查均为细菌学阳性（阳性-阳性），34.9%的患者两次检查均为阴性（阴性-阴性）。与首次发作时细菌学阴性的复发性 PTB 相比，细菌学阳性病例中男性比例更高（81.70% vs 72.79%；P<0.001），死亡率更高（1.78% vs 0.92%；P=0.003），治愈或完成治疗的比例更低（82.81% vs 84.97%；P=0.022），从发病到治疗结束的时间更长。细菌学阳性病例的复发概率高于细菌学阴性病例（20 个月时分别为 0.5%和 0.4%；P<0.05）。
根据患者的流行病学特征和细菌学类型，有必要积极采取措施控制其复发。
