Research article
Tuberculosis recurrence in smear-positive patients cured under DOTS in southern Ethiopia: retrospective cohort study
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* Corresponding author: Daniel G Datiko danieljohn42@yahoo.com
1 Centre for International Health, University of Bergen, Overlege Danielsens Hus, Årstadveien 21, 5009 Bergen, Norway
2 Southern Nations, Nationalities, and Peoples' Regional Health Bureau, PO Box 149, Hawassa, Ethiopia
BMC Public Health 2009, 9:348 doi:10.1186/1471-2458-9-348
Published: 18 September 2009Abstract
Background
Decentralization of DOTS has increased the number of cured smear-positive tuberculosis (TB) patients. However, the rate of recurrence has increased mainly due to HIV infection. Recurrence rate could be taken as an important measure of long-term success of TB treatment. We aimed to find out the rate of recurrence in smear-positive patients cured under DOTS in southern Ethiopia.
Methods
We did a retrospective cohort study on cured smear-positive TB patients who were treated from 1998 to 2006. Recurrence of smear-positive TB was used as an outcome measure. Person-years of observation (PYO) were calculated per 100 PYO from the date of cure to date of interview. Kaplan-Meier and Cox-regression methods were used to determine the survival and the hazard ratio (HR).
Results
368 cured smear-positive TB patients which were followed for 1463 person-years. Of these, 187 patients (50.8%) were men, 277 patients (75.5%) were married, 157 (44.2%) were illiterate, and 152 patients (41.3%) were farmers. 15 of 368 smear-positive patients had recurrence. The rate of recurrence was 1 per 100 PYO (0.01 per annum). Recurrence was not associated with age, sex, occupation, marital status and level of education.
Conclusion
High recurrence rate occurred among smear-positive patients cured under DOTS. Further studies are required to identify factors contributing to high recurrence rates to improve disease free survival of TB patients after treatment.