Factors influencing the successful treatment of infectious pulmonary tuberculosis.

SETTING: Achieving successful treatment of infectious pulmonary tuberculosis (PTB) could reduce the spread of tuberculosis (TB) and the emergence of multidrug resistance. OBJECTIVE: To explore factors associated with successful treatment for sputum-positive PTB. DESIGN: This study used a population-based retrospective cohort design. All PTB patients residing in southern Taiwan recorded in the tuberculosis registry from 1 January to 30 June 2003 were identified. Each patient's medical record was requested from treating hospitals and retrospectively reviewed for 15 months after the date PTB was confirmed. RESULTS: There were 399 PTB patients included in the study. Factors significantly associated with successful treatment included treatment by pulmonologists (OR 1.93), receiving directly observed therapy (DOT) (OR 1.76) and receiving treatment at the chest hospital (OR 5.41). Patients of advanced age were less likely to achieve treatment success (OR 0.97). Among patients treated by pulmonologists, those treated at the chest hospital had a significantly higher treatment success rate than those treated at other institutions (94.1% vs. 69.9%). CONCLUSIONS: Patients treated with DOT and by pulmonologists, especially at the chest hospital, had a higher treatment success rate. DOT and training of care professionals and institutions are therefore important factors that affect the successful treatment of TB.