Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan.
OBJECTIVES: To determine the effect of directly observed therapy (DOT) on tuberculosis-specific mortality and non-TB-specific mortality and identify prognostic factors associated with mortality among adults with culture-positive pulmonary TB (PTB). METHODS: All adult Taiwanese with PTB in Taipei, Ta...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3838349?pdf=render |
| _version_ | 1818315975582285824 |
|---|---|
| author | Yung-Feng Yen Muh-Yong Yen Yi-Ping Lin Hsiu-Chen Shih Lan-Huei Li Pesus Chou Chung-Yeh Deng |
| author_facet | Yung-Feng Yen Muh-Yong Yen Yi-Ping Lin Hsiu-Chen Shih Lan-Huei Li Pesus Chou Chung-Yeh Deng |
| author_sort | Yung-Feng Yen |
| collection | DOAJ |
| description | OBJECTIVES: To determine the effect of directly observed therapy (DOT) on tuberculosis-specific mortality and non-TB-specific mortality and identify prognostic factors associated with mortality among adults with culture-positive pulmonary TB (PTB). METHODS: All adult Taiwanese with PTB in Taipei, Taiwan were included in a retrospective cohort study in 2006-2010. Backward stepwise multinomial logistic regression was used to identify risk factors associated with each mortality outcome. RESULTS: Mean age of the 3,487 patients was 64.2 years and 70.4% were male. Among 2471 patients on DOT, 4.2% (105) died of TB-specific causes and 15.4% (381) died of non-TB-specific causes. Among 1016 patients on SAT, 4.4% (45) died of TB-specific causes and 11.8% (120) died of non-TB-specific causes. , After adjustment for potential confounders, the odds ratio for TB-specific mortality was 0.45 (95% CI: 0.30-0.69) among patients treated with DOT as compared with those on self-administered treatment. Independent predictors of TB-specific and non-TB-specific mortality included older age (ie, 65-79 and ≥80 years vs. 18-49 years), being unemployed, a positive sputum smear for acid-fast bacilli, and TB notification from a general ward or intensive care unit (reference: outpatient services). Male sex, end-stage renal disease requiring dialysis, malignancy, and pleural effusion on chest radiography were associated with increased risk of non-TB-specific mortality, while presence of lung cavities on chest radiography was associated with lower risk. CONCLUSIONS: DOT reduced TB-specific mortality by 55% among patients with PTB, after controlling for confounders. DOT should be given to all TB patients to further reduce TB-specific mortality. |
| first_indexed | 2024-12-13T09:14:05Z |
| format | Article |
| id | doaj.art-ea2e47c93cde4924862a3d1d9ba474b9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T09:14:05Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ea2e47c93cde4924862a3d1d9ba474b92022-12-21T23:52:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e7964410.1371/journal.pone.0079644Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan.Yung-Feng YenMuh-Yong YenYi-Ping LinHsiu-Chen ShihLan-Huei LiPesus ChouChung-Yeh DengOBJECTIVES: To determine the effect of directly observed therapy (DOT) on tuberculosis-specific mortality and non-TB-specific mortality and identify prognostic factors associated with mortality among adults with culture-positive pulmonary TB (PTB). METHODS: All adult Taiwanese with PTB in Taipei, Taiwan were included in a retrospective cohort study in 2006-2010. Backward stepwise multinomial logistic regression was used to identify risk factors associated with each mortality outcome. RESULTS: Mean age of the 3,487 patients was 64.2 years and 70.4% were male. Among 2471 patients on DOT, 4.2% (105) died of TB-specific causes and 15.4% (381) died of non-TB-specific causes. Among 1016 patients on SAT, 4.4% (45) died of TB-specific causes and 11.8% (120) died of non-TB-specific causes. , After adjustment for potential confounders, the odds ratio for TB-specific mortality was 0.45 (95% CI: 0.30-0.69) among patients treated with DOT as compared with those on self-administered treatment. Independent predictors of TB-specific and non-TB-specific mortality included older age (ie, 65-79 and ≥80 years vs. 18-49 years), being unemployed, a positive sputum smear for acid-fast bacilli, and TB notification from a general ward or intensive care unit (reference: outpatient services). Male sex, end-stage renal disease requiring dialysis, malignancy, and pleural effusion on chest radiography were associated with increased risk of non-TB-specific mortality, while presence of lung cavities on chest radiography was associated with lower risk. CONCLUSIONS: DOT reduced TB-specific mortality by 55% among patients with PTB, after controlling for confounders. DOT should be given to all TB patients to further reduce TB-specific mortality.http://europepmc.org/articles/PMC3838349?pdf=render |
| spellingShingle | Yung-Feng Yen Muh-Yong Yen Yi-Ping Lin Hsiu-Chen Shih Lan-Huei Li Pesus Chou Chung-Yeh Deng Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan. PLoS ONE |
| title | Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan. |
| title_full | Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan. |
| title_fullStr | Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan. |
| title_full_unstemmed | Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan. |
| title_short | Directly observed therapy reduces tuberculosis-specific mortality: a population-based follow-up study in Taipei, Taiwan. |
| title_sort | directly observed therapy reduces tuberculosis specific mortality a population based follow up study in taipei taiwan |
| url | http://europepmc.org/articles/PMC3838349?pdf=render |
| work_keys_str_mv | AT yungfengyen directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan AT muhyongyen directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan AT yipinglin directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan AT hsiuchenshih directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan AT lanhueili directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan AT pesuschou directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan AT chungyehdeng directlyobservedtherapyreducestuberculosisspecificmortalityapopulationbasedfollowupstudyintaipeitaiwan |