Identifying Predictors of Unfavorable Treatment Outcomes in Tuberculosis Patients

Ji Yeon Lee, Jun-Pyo Myong, Younghyun Kim, Ina Jeong, Joohae Kim, Sooim Sin, Yunhyung Kwon, Chieeun Song and Joon-Sung Joh ()
Additional contact information
Ji Yeon Lee: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
Jun-Pyo Myong: Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
Younghyun Kim: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
Ina Jeong: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
Joohae Kim: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
Sooim Sin: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea
Yunhyung Kwon: Division of Tuberculosis Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju 28159, Republic of Korea
Chieeun Song: Division of Tuberculosis Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju 28159, Republic of Korea
Joon-Sung Joh: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul 04564, Republic of Korea

IJERPH, 2024, vol. 21, issue 11, 1-14

Abstract: Objectives: In South Korea, there has been a continuous decrease in the incidence of tuberculosis (TB) attributable to a national TB elimination program; however, TB still poses a significant socioeconomic burden. This study aimed to analyze factors associated with successful TB treatment and to identify refractory patient groups with unfavorable outcomes. Methods: We analyzed anonymized data on 89,150 patients with TB provided by the Korea Disease Control and Prevention Agency. Specifically, we collected independent variables, which were categorized as individual, regional, and medical facility factors. Individual factors included age, sex, nationality, TB type, drug-resistant status, category of TB, housing type, underlying disease status, number of referrals, and smoking status. Regional factors referred to the region where the TB case was reported. Medical facility factors included the first visit to a medical facility, categorized by hospital type and the distinction between private–public mix (PPM) and non-PPM depending on the presence or absence of dedicated TB nurses. These factors were analyzed in relation to treatment success to identify refractory patient groups with unfavorable outcomes. Results: Multivariable logistic regression analysis revealed the following significant factors associated with successful TB treatment: sex, nationality, status of drug-resistant TB, category of TB, number of referrals, region of TB registry, underlying diseases, and smoking status. Specifically, compared with their relevant counterparts, male patients had a lower rate of successful treatment (adjusted odds ratio [aOR]: 0.66, reference [Ref.]: women); Korean nationals had a higher rate of treatment success (aOR: 7.20, Ref. foreign residents in Korea); resistant TB was associated with a lower rate of treatment success (aOR: 0.35, Ref.: non-resistant TB status); newly treated patients had a higher rate of treatment success (aOR: 1.75, Ref.: retreatment patient); switching hospitals once (aOR: 1.78), never (aOR: 1.41), or twice (aOR: 1.37) was associated with increased treatment success (Ref.: three or more times); having zero (aOR: 1.45), one (aOR: 1.31), or two (aOR: 1.24) underlying diseases was associated with a higher rate of treatment success (Ref. three or more underlying diseases); and past smokers (aOR: 1.40) and non-smokers (aOR: 1.35) had a higher rate of treatment success (Ref.: current smokers). Conclusions: Our study identified several factors contributing to unfavorable treatment outcomes in tuberculosis patients, including male patients, foreign residents in Korea, drug-resistant TB, retreatment patients, frequent hospital switching, multiple underlying diseases, and current smoking status. These research findings could inform the development of efficient management strategies and policies for improving the treatment success rate among patients with TB.

Keywords: tuberculosis; unfavorable outcomes; multivariable logistic; regression analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/21/11/1454/pdf (application/pdf)
https://www.mdpi.com/1660-4601/21/11/1454/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:21:y:2024:i:11:p:1454-:d:1511675

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().