Study On Anti-tuberculosis Treatment Effect Of Pulmonary Tuberculosis Under DOTS In Yunnan Province

[Objectives] To evaluate the anti-tuberculosis (TB) treatment effect of the smear-positive pulmonary TB in Yunnan. To explore potential influencing factors on treatment effect, especially focusing on drug sensitivity test (DST) results.[Method] Anti-TB treatment effect with influencing factors was evaluated in this descriptive research through analyzing data of smear-positive TB cases from TB management information system between2005and2010. Results of DST including isoniazid, rifampicin, streptomycin, ethambutol, ofloxacin and kanamycin were collected for smear-positive pulmonary TB cases registed from2008to2010at32counties in Yunnan province. At last anti-TB treatment outcome of first-line drug was evaluated for those cases.[Result] During2005to2010, the treatment success rate of smear-positive pulmonary TB cases was increased from90.30%to97.02%. Overall drug resistant percentage of smear-positive TB cases was37.91%(new cases34.19%, retreatment cases55.96%) of TB drug resistance monitoring program during2008to2010.There were259single drug-resistant cases (20.33%),129cases poly drug resistant cases (10.13%),95multi-drug resistant (including extensively drug-resistant) cases (7.46%).The success rates of treatment of single drug resistance, poly drug resistance and multi-drug resistance of smear-positive TB cases were94.44%,95.63%,95.97%and57.30%, respectively. Logistic regression multivariate analysis results showed that the influencing factors of smear-positive TB treatment success included age, the first time diagnosis unit, type of drug resistance, resistance to ofloxacin, treatment category, with adverse drug reaction and live with other diseases, actual treatment management approach, sputum smear examination results of the2nd month.[Conclusion] There has had a downtrend of TB reported morbidity and mortality of under DOTS strategy implementation in Yunnan Province, and a escalating trend of treatment success rate among smear-positive TB cases. The first-line anti-TB drug standard chemotherapy regimen of DOTS strategy, for the sensitive, single and poly drug resistance smear-positive TB cases, showed higher treatment success rate, but low TB treatment success rate for multi-drug resistant cases. The treatment effect of cases,, who are old people(≥65years old), retreatment, non-local census register, with adverse drug reaction and live with other diseases, multi-drug resistant, without full-course supervision, are worse.