Valeria Zhdanov1, Natalya Bilenko1,2, Zohar Mor3,4. 1. Department of Public Health, Faculty of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel. 2. Ashkelon Department of Health, Ministry of Health, Israel. 3. Tel Aviv Department of Health, Ministry of Health, Israel. 4. School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: Recurrent tuberculosis (TB) is one of the indices used to assess the effectiveness of the Israeli National TB Programs (NTP). OBJECTIVES: To estimate the incidence of recurrent TB in Israel and to identify the associated risk factors. METHODS: We conducted a retrospective cohort study of all TB patients who were Israeli citizens and diagnosed between 1999 and 2011 with a treatment outcome recorded as "success." We compared those who had recurrent TB with those who did not. In addition, a nested case-control study included all those who had recurrent TB with a random sample from this cohort matched by age, gender, and year of TB diagnosis. RESULTS: Of 3515 TB patients diagnosed between 1999 and 2011, 37 (1.05%) had recurrent TB during the follow-up period, with an incidence rate of 1.55 cases per 1000 person-years (PY). Male gender [hazard ratio (HR) 3.2, 95% confidence interval (95%CI) 1.4-7.4], human immunodeficiency virus (HIV) infection (HR 3.9, 95%CI 1.5-10.4), positive sputum culture [odds ratios (OR) 2.7, 95%CI 1.1-6.9], and low adherence to anti-TB treatment (OR 3.2, 95%CI 1.0-10.3) were found to be risk factors for recurrent TB. CONCLUSIONS: Male gender, HIV infection, positive sputum culture, and low adherence to anti-TB drugs during the initial TB episode were risk factors for developing recurrent TB.
BACKGROUND: Recurrent tuberculosis (TB) is one of the indices used to assess the effectiveness of the Israeli National TB Programs (NTP). OBJECTIVES: To estimate the incidence of recurrent TB in Israel and to identify the associated risk factors. METHODS: We conducted a retrospective cohort study of all TB patients who were Israeli citizens and diagnosed between 1999 and 2011 with a treatment outcome recorded as "success." We compared those who had recurrent TB with those who did not. In addition, a nested case-control study included all those who had recurrent TB with a random sample from this cohort matched by age, gender, and year of TB diagnosis. RESULTS: Of 3515 TB patients diagnosed between 1999 and 2011, 37 (1.05%) had recurrent TB during the follow-up period, with an incidence rate of 1.55 cases per 1000 person-years (PY). Male gender [hazard ratio (HR) 3.2, 95% confidence interval (95%CI) 1.4-7.4], human immunodeficiency virus (HIV) infection (HR 3.9, 95%CI 1.5-10.4), positive sputum culture [odds ratios (OR) 2.7, 95%CI 1.1-6.9], and low adherence to anti-TB treatment (OR 3.2, 95%CI 1.0-10.3) were found to be risk factors for recurrent TB. CONCLUSIONS: Male gender, HIV infection, positive sputum culture, and low adherence to anti-TB drugs during the initial TB episode were risk factors for developing recurrent TB.
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