Recurrence and risk factors to the pulmonary tuberculosis patients after successful initial treatment in Beijing

Abstract

Objective To analyze the recurrence and risk factors of pulmonary tuberculosis (TB) cases after successful initial treatment in Beijing. Methods A retrospective cohort study was conducted. The data of pulmonary TB cases with successful initial treatment in Beijing during 2015–2017 were collected from TB information management system. The medical records and infectious disease report cards registered or reported before December 31, 2020 were collected to find recurrent TB cases and survival analysis was performed. The recurrence of TB was estimated by using life-table method, Kaplan-Meier method was used for univariate analysis of recurrence, log-rank method was used for comparison between groups, and time-dependent Cox regression model was used for multivariate analysis. Results Of the 8 503 TB cases with successful initial treatment enrolled in Beijing, 253 (2.98%) had recurrence, with a recurrence rate density of 8.13/1000 person-years, in which 88.54% (224 cases) had recurrence within 3 years, and 3.57% had recurrence within 5 years. Multivariate analysis based on univariate analysis showed that, lung cavity (adjusted Hazard ratio, aHR =1.592, 95% CI: 1.166–2.172, P=0.003), time-dependent covariates such as age (aHR=1.004, 95% CI: 1.001–1.008, P=0.008), passive treatment (aHR=1.200, 95% CI: 1.008–1.428, P=0.040), being etiologically positive (aHR=1.154, 95% CI: 1.034–1.289, P=0.011) were the independent risk factors for TB recurrence. Conclusion We should strengthen the follow-up and management of pulmonary TB patients after successful treatment, and conduct targeted intervention for groups at high-risk for TB recurrence. Health education for the general people should be strengthened, and early detection and early treatment of TB cases should be performed to reduce TB recurrence.