Treatment outcome of pulmonary tuberculosis in eastern Taiwan - Experience at a Medical Center

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. Methods: 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. Results: 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. Conclusion: 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.