Outcome of Tuberculosis Treatment: A Comparison between Alberta and Nicaragua

Abstract

To measure the outcome of tuberculosis treatment in a low incidence, high income region, Alberta, and compare with an intermediate incidence, low income country with a model national tuberculosis program, Nicaragua. All 1992 sputum smear-positive pulmonary cases from both regions were included. Treatment outcome was assigned retrospectively to Alberta cases according to the International Union Against Tuberculosis and Lung Diseases' (IUATLD) criteria of cure, failure, transfer, absconder and death. Alberta laboratories are required to report all Mycobacterium tuberculosis cultures to Alberta provincial tuberculosis services. Nicaragua cases are reported centrally to the Programa de control de tuberculosis in Managua using the IUATLD criteria. In Alberta, 222 tuberculosis cases were identified, of which 61 were smear positive. Nicaragua had 1552 smear positive cases of 2885 tuberculosis cases. Alberta's outcomes were 82% cured, no failed treatment, 5% absconded, 2% transferred and 11% died; Nicaragua's outcomes were 77% cured, 2% failed, 13% absconded, 5% transferred and 4% died. There was no significant difference in cure rates between Alberta and Nicaragua, P=0.33. Treatment outcomes can be measured effectively and reported in high income, low incidence settings. Alberta is achieving comparable cure rates with the Nicaraguan national tuberculosis program.