Treatment outcome of extra-pulmonary tuberculosis in Finland: a cohort study

Vasankari, Tuula; Holmström, Pekka; Ollgren, Jukka; Liippo, Kari; Ruutu, Petri
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p399
Academic Journal
Background: We investigated the treatments given, the outcome and the patient- and treatment-system dependent factors affecting treatment outcome in a national two-year cohort of culture-verified extra-pulmonary tuberculosis cases in Finland. Methods: Medical records of all cases in 1995 -1996 were ed to assess treatment and outcome, using the European recommendations for outcome monitoring. For risk factor analysis, outcome was divided into three groups: favourable, death and other unfavourable. Predictors of unfavourable outcome were assessed in univariate and multivariate analysis. Results: In the study cohort of 276 cases, 116 (42.0%) were men and 160 (58.0%) women. The mean age was 65.7 years. A favourable outcome was achieved in 157/276 (56.9%) cases, consisting of those cured (8.0%) and treatment completed (48.9%). Death was the outcome in 17.4% (48/276) cases, including cases not treated. Other unfavourable outcomes took place in 45 (16.3%) cases. Significant independent risk factors for death in multinomial logistic regression model were male sex, high age, immunosuppression, any other than a pulmonary specialty being responsible at the end of the treatment and other than standard combination of treatment. For other unfavourable treatment outcomes, significant risk factor was treatment with INH + RIF + EMB/SM. Deep site of TB was inversely associated with the risk of other unfavourable outcome. Conclusions: The proportion of favourable outcome was far below the goal set by the WHO. Age and comorbidities, playing an important role in treatment success, are not available in routine outcome data. Therefore, comparisons between countries should be made in cohort analyses incorporating data on comorbidities.


Related Articles

  • Five-years experiences of the Revised National Tuberculosis Control Programme in northern part of Kolkata, India. Pandit, Sudipta; Dey, Atin; Chaudhuri, Arunabha Datta; Saha, Mita; Sengupta, Amitava; Kundu, Sushmita; Bhuniya, Sourin; Shib Singh // Lung India;2009, Vol. 26 Issue 4, p109 

    Background: The Revised National Tuberculosis Control programme (RNTCP), India. Aim: To assess the impact of the expansion of the RNTCP in the case detection and treatment outcome. Materials and Methods: Reports of patients with tuberculosis (TB) diagnosed and treated under RNTCP from 2001 to...

  • Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia. A five - year retrospective study. Tessema, Belay; Muche, Abebe; Bekele, Assegedech; Reissig, Dieter; Emmrich, Frank; Sack, Ulrich // BMC Public Health;2009, Vol. 9 Issue 1, p371 

    Background: In Gondar University Teaching Hospital standardized tuberculosis prevention and control programme, incorporating Directly Observed Treatment, Short Course (DOTS) started in 2000. According to the proposal of World Health Organization (WHO), treatment outcome is an important indicator...

  • How does my doctor treat TB disease?  // Tuberculosis: Getting Healthy, Staying Healthy;Jun2008, Issue 8, p12 

    The article provides an answers to a question of how physicians treat tuberculosis (TB) disease.

  • Recurrence after Treatment for Pulmonary Multidrug-Resistant Tuberculosis. Becerra, Mercedes C.; Appleton, Sasha C.; Franke, Molly F.; Chalco, Katiuska; Bayona, Jaime; Murray, Megan B.; Mitnick, Carole D. // Clinical Infectious Diseases;9/15/2010, Vol. 51 Issue 6, p709 

    We estimated the proportion of recurrence within 2 years among adults cured by individualized multidrug-resistant tuberculosis regimens in Peru. Among 310 individuals with at least 24 months of follow-up, 16 experienced an episode of recurrent tuberculosis. If we assume the worst for treatment...

  • Poor adherence not enough to cause development of MDR-TB. Carter, Michael // CME: Continuing Medical Education;Nov/Dec2011, Vol. 29 Issue 11/12, p482 

    The article details a laboratory study published in the online edition of the "Journal of Infectious Diseases" which suggests that poor adherence is not enough to cause multidrug-resistent tuberculosis (MDR-TB). According to the study, failure of management of tuberculosis results from extremely...

  • A VERY SERIOUS NEW DISEASE - EXTENDED DRUGRESISTANT TUBERCULOSIS (XDR TB). Mitrea, Mirela; Birlutiu, Victoria; Deac, M. // Acta Medica Transilvanica;sep2011, Vol. 16 Issue 3, p329 

    Compared to germ sensitive tuberculosis (TB), in the case of multi-drug resistant (MDR TB) or extended drug-resistant tuberculosis (XDR TB) the prognosis is unfavourable, by prolonging therapy and its success is relatively limited. Early diagnosis and swift establishment of the target therapy...

  • Rifampin-associated tubulointersititial nephritis and Fanconi syndrome presenting as hypokalemic paralysis. Hong Ki Min; Oh Kim; Sang Ju Lee; Yoon Kyung Chang; Kwang Sun Suh; Chul Woo Yang; Suk Young Kim; Hyeon Seok Hwang // BMC Nephrology;2013, Vol. 14 Issue 1, p1 

    Background: Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN) is a frequent histological finding. We describe for the first time a case of ATIN and...

  • New TB Strategy. Stephenson, Joan // JAMA: Journal of the American Medical Association;3/16/2005, Vol. 293 Issue 11, p1316 

    Reports on research from Korea which suggests that combining standard TB drug therapy with a vaccine containing M tuberculosis DNA might offer a cure. Experiments with mice with standard drugs or the combination in which reactivated infections were seen in 6 to 10 mice on standard therapy...

  • Tuberculosis in an Urban Area in China: Differences between Urban Migrants and Local Residents. Xin Shen; Zhen Xia; Xiangqun Li; Jie Wu; Lili Wang; Jing Li; Yuan Jiang; Juntao Guo; Jing Chen; Jianjun Hong; Zheng'an Yuan; Qichao Pan; DeRiemer, Kathryn; Guomei Sun; Qian Gao; Jian Mei // PLoS ONE;Nov2012, Vol. 7 Issue 11, Special section p1 

    Background: The increase in urban migrants is one of major challenges for tuberculosis control in China. The different characteristics of tuberculosis cases between urban migrants and local residents in China have not been investigated before. Methodology/Principal Findings: We performed a...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics