Background To improve the treatment outcomes for tuberculosis (TB) efforts to reduce treatment failure are necessary. The aim of our study was to describe the characteristics of subjects who had failed treatment of tuberculosis and identify the risk factors for treatment failure and poor compliance using national data.
Methods A multicenter cross-sectional study was performed for tuberculosis subjects whose final outcome was reported as treatment failure during 2015–2017. The same number of subjects with treatment success during the same study period were randomly selected for comparison. Demographics, microbiological, radiographic, and clinical data were collected based on in-depth interviews by TB nurse specialists at all Public Private Mix (PPM) participating hospitals in South Korea.
Results A total of 52 tuberculosis patients with treatment failure were enrolled. In a multivariable analysis, the presence of diabetes, previous history of tuberculosis, and cavity were identified as risk factors for treatment failure; and Medicaid support was a favorable factor for treatment success (area under the curve (AUC): 0.76). Age, diabetes, pre-existing lung disease, positive sputum acid-fast bacilli (AFB) smear result, and presence of multi-drug-resistant tuberculosis (MDR-TB) were significantly associated with presence of cavity. Younger age, and lower body mass index (BMI) were associated with poor compliance during treatment (AUC: 0.74).
Conclusion To reduce treatment failure, careful evaluation for the presence of diabetes, underlying lung disease, cavity, results of sputum AFB smears, and socioeconomic status is needed. To enhance treatment compliance, more attention should be paid to younger patients with lower BMIs during follow-up.