Risk Factors of Retreatment Pulmonary Tuberculosis Patients with Unfavorable Treatment Outcome in China: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YINShao-hua ¹ ^# ,  DUMao-lin ¹ ^# , DUJian ² , WUJing ³ , WANGPei-yu ⁴ , SHUWei ¹ , HAORui-qi ¹ , LIShi-yuan ¹ , LIANGDan-yan ¹ , WANGRui-qi ¹ ,  WANGXue-mei ¹

1. School of Public Health, Inner Mongolia Medical University, Hohhot 010110, China;
2. Beijing Chest Hospital, Capital Medical University/Clinical Center on Tuberculosis Control, China Center of Disease Control, Beijing 101149, China;
3. Division for NCD Control and Prevention and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
4. Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China;

Corresponding?author：

WANGXue-mei, Email: wangxm_zsu@163.com

Keywords：

Tuberculosis, pulmonary; Retreatment; Unfavorable treatment outcome; Treatment failure; Meta-analysis

DOI：

10.7507/1672-2531.20160123

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the risk factors of retreatment pulmonary tuberculosis with unfavorable treatment outcome. Methods We electronically searched databases including CNKI, VIP, CBM and WanFang Date from inception to November 15^th 2015, to collect studies about the risk factors of retreatment pulmonary tuberculosis patients with unfavorable treatment outcome. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 software. Results A total of 13 studies were included. The results of meta-analysis showed that significant association was found between retreatment pulmonary tuberculosis cases with unfavorable treatment outcome and such factors as the standard retreatment regimen (OR=4.98, 95%CI 2.95 to 8.39, P < 0.00001), drug-resistance (OR=4.22, 95%CI 1.85 to 9.63, P=0.0006), multi-drug resistance (OR=7.19, 95%CI 2.51 to 20.58, P=0.0002), status of cavitas (OR=1.80, 95%CI 1.20 to 2.71, P=0.005), TB-diabetes mellitus (OR=2.05, 95%CI 1.30 to 3.22, P=0.002) and high sputum smear load >2+(OR=2.07, 95%CI 1.30 to 3.29, P=0.002) in univariate-analysis, respectively. But, in multivariate-analysis, only TB-diabetes mellitus (OR=3.38, 95%CI 1.56 to 7.29, P=0.002) showed significant association with retreatment pulmonary tuberculosis cases with unfavorable treatment outcome. Conclusion Current evidence shows that TB-diabetes mellitus, standard retreatment regimen, drug-resistance, multi-drug resistance, status of cavitas and high sputum smear load >2+ are considered to be the risk factors for retreatment pulmonary tuberculosis cases with unfavorable treatment outcome. Especially, for patients with diabetes, the importance of management need to be reinforced to reduce the failure rate in the retreatment of pulmonary tuberculosis. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： YINShao-hua, DUMao-lin, DUJian, WUJing, WANGPei-yu, SHUWei, HAORui-qi, LIShi-yuan, LIANGDan-yan, WANGRui-qi, WANGXue-mei. Risk Factors of Retreatment Pulmonary Tuberculosis Patients with Unfavorable Treatment Outcome in China: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(7): 795-801. doi: 10.7507/1672-2531.20160123 Copy

1.	World Health Organization. Global Tuberculosis Report 2015. Geneva:WHO, 2015:1-149.
2.	Reis-Santos B, Gomes T, Locatelli R, et al. Treatment outcomes in tuberculosis patients with diabetes:a polytomous analysis using Brazilian surveillance system. PLoS One, 2014, 9(7):e100082.
3.	Kritski AL, Rodrigues de Jesus LS, Andrade MK, et al. Retreatment tuberculosis cases. Factors associated with drug resistance and adverse outcomes. Chest, 1997, 111(5):1162-1167.
4.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9):603-605.
5.	Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version5.0.0[update February 2008]. The Cochrane Collaboration, 2008. Available at:www.cochrane-handbook.org.
6.	韓旻雁, 銀恭舉, 陳維清.中國人群鼻咽癌發病危險因素Meta分析.中國熱帶醫學, 2005, 5(07):1442-1443.
7.	Hamling J, Lee P, Weitkunat R, et al. Facilitating meta-analyses by deriving relative effect and precision estimates for alternative comparisons from a set of estimates presented by exposure level or disease category. Stat Med, 2008, 27(7):954-970.
8.	李曉松.醫學統計學.北京:高等教育出版社, 2008:1-471.
9.	陳長生, 徐勇勇.第十四講如何進行meta分析.中華預防醫學雜志, 2003, 37(2):138-140.
10.	范玉美.首次復治肺結核病人療效影響的因素分析.江蘇:蘇州大學, 2006.
11.	黃勇. 2003-2007年阿壩州涂陽肺結核發現和治療分析.寄生蟲病與感染性疾病, 2008, 6(4):193-196.
12.	唐恒發. 213例復治涂陽肺結核病例轉歸的影響因素分析.安徽預防醫學雜志, 2008, 14(4):250-252.
13.	范冀緩, 謝艷光, 何廣學, 等.黑龍江省耐藥監測項目中肺結核治療失敗的原因分析.中國防癆雜志, 2009, 31(12):681-685.
14.	王靜, 羅萍, 洪峰, 等. 223例復治涂陽肺結核患者治療現狀分析.中國防癆雜志, 2010, 32(7):376-379.
15.	杜建, 徐彩紅, 楊應周, 等.標準短程化療方案治療初治復治肺結核失敗原因分析.中國病原生物學雜志, 2012, 7(7):523-526.
16.	李鵬鵬, 張宏蘭, 孫凱成. 352例復治涂陽肺結核患者治療效果分析.臨床肺科雜志, 2012, 17(4):669-670.
17.	段瓊紅, 陳聰, 張正斌, 等.武漢市首次復治涂陽肺結核治療結局及影響因素分析.中國防癆雜志, 2013, 35(10):788-792.
18.	張志進. 416例復治涂陽肺結核患者治療轉歸及影響因素分析.中外健康文摘, 2013, (38):872-73.
19.	孫釗, 孟煒麗, 李慧穎, 等.標準復治方案對復治菌陽肺結核患者的療效觀察.北京醫學, 2014, 36(6):491-492.
20.	杜建, 高微微, 馬艷, 等.優化方案和規范化方案對復治肺結核合并糖尿病的療效.中華結核和呼吸雜志, 2015, 38(12):886-891.
21.	胡潔.嘉興市結核病耐藥情況及復治肺結核患者治療方案比較的研究.浙江:浙江大學, 2015.
22.	李莉, 孫建勝, 張海清, 等.耐多藥結核病成因及治療效果的分析.預防醫學論壇, 2015, 21(8):568-572.
23.	Alisjahbana B, Sahiratmadja E, Nelwan EJ, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis, 2007, 45(4):428-435.
24.	Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus:convergence of two epidemics. Lancet Infect Dis, 2009, 9(12):737-746.
25.	Dooley KE, Tang T, Golub JE, et al. Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis. Am J Trop Med Hyg, 2009, 80(4):634-639.
26.	Baker MA, Harries AD, Jeon CY, et al. The impact of diabetes on tuberculosis treatment outcomes:a systematic review. BMC Med, 2011, 9(81):1-15.
27.	何權瀛, 張波.應高度重視免疫功能低下患者的肺部感染.中華結核和呼吸雜志, 2012, 33(10):721-722.
28.	Nijland HM, Ruslami R, Stalenhoef JE, et al. Exposure to rifampicin is strongly reduced in patients with tuberculosis and type 2 diabetes. Clin Infect Dis, 2006, 43(7):848-854.
29.	Lenjisa J. Assessment of Tuberculosis Retreatment Case Rate and Its Treatment Outcomes at Adama Hospital Medical College, East Showa, Ethiopia. J Steroids Horm Sci, 2015, 06(1):1-6.
30.	Jones-Ló pez EC, Ayakaka I, Levin J, et al. Effectiveness of the standard WHO recommended retreatment regimen (category II) for tuberculosis in Kampala, Uganda:a prospective cohort study. PLoS Med, 2011, 8(3):e1000427.
31.	Mpagama SG, Lekule IA, Mbuya AW, et al. The Influence of Mining and Human Immunodeficiency Virus Infection Among Patients Admitted for Retreatment of Tuberculosis in Northern Tanzania. Am J Trop Med Hyg, 2015, 93(2):212-215.
32.	Matthys F, Rigouts L, Sizaire V, et al. Outcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis. PLoS One, 2009, 4(11):e7954.
33.	Kritski AL, Rodrigues De Jesus LS, Andrade MK, et al. Retreatment tuberculosis cases. Factors associated with drug resistance and adverse outcomes. Chest, 1997, 111(5):1162-1167.
34.	Espinal MA, Kim SJ, Suarez PG, et al. Standard short-course chemotherapy for drug-resistant tuberculosis:treatment outcomes in 6 countries. JAMA, 2000, 283(19):2537-2545.
35.	He GX, Xie YG, Wang LX, et al. Follow-up of patients with multidrug resistant tuberculosis four years after standardized first-line drug treatment. PLoS One, 2010, 5(5):e10799.
36.	Green E, Obi CL, Nchabeleng M, et al. Drug-susceptibility patterns of Mycobacterium tuberculosis in Mpumalanga province, South Africa:possible guiding design of retreatment regimen. J Health Popul Nutr, 2010, 28(1):7-13.
37.	Mak A, Thomas A, Del Granado M, et al. Influence of multidrug resistance on tuberculosis treatment outcomes with standardized regimens. Am J Respir Crit Care Med, 2008, 178(3):306-312.
38.	Ogbera AO, Kapur A, Abdur-Razzaq H, et al. Clinical profile of diabetes mellitus in tuberculosis. BMJ Open Diabetes Res Care, 2015, 3(1):e000112.
39.	Tabarsi P, Chitsaz E, Tabatabaei V, et al. Revised Category II regimen as an alternative strategy for retreatment of Category I regimen failure and irregular treatment cases. Am J Ther, 2011, 18(5):343-349.
40.	Takarinda KC, Harries AD, Srinath S, et al. Treatment outcomes of adult patients with recurrent tuberculosis in relation to HIV status in Zimbabwe:a retrospective record review. BMC Public Health, 2011, 12(12):124.
41.	World Health Organization. Global Tuberculosis Report 2013, Geneva:WHO.
42.	Han LL, Sloutsky A, Canales R, et al. Acquisition of drug resistance in multidrug-resistant Mycobacterium tuberculosis during directly observed empiric retreatment with standardized regimens. Int J Tuberc Lung Dis, 2005, 9(7):818-821.
43.	Faustini A, Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe:a systematic review. Thorax, 2006, 61(2):158-163.
44.	Denholm J. The most recent report from the World Health Organization found that, worldwide, approximately 5% of new tuberculosis cases are caused by multidrug-resistant strains (MDR TB). J Travel Med, 2010, 17(3):216.
45.	Pieroni M, Tipparaju SK, Lun S, et al. Pyrido[1, 2-a]benzimidazole-based agents active against tuberculosis(TB), multidrug-resistant(MDR) TB and extensively drug-resistant(XDR) TB. ChemMedChem, 2011, 6(2):334-342.
46.	Prammananan T, Chaiprasert A, Leechawengwongs M. In vitro activity of linezolid against multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant (XDR)-TB isolates. Int J Antimicrob Agents, 2009, 33(2):190-191.

1. World Health Organization. Global Tuberculosis Report 2015. Geneva:WHO, 2015:1-149.
2. Reis-Santos B, Gomes T, Locatelli R, et al. Treatment outcomes in tuberculosis patients with diabetes:a polytomous analysis using Brazilian surveillance system. PLoS One, 2014, 9(7):e100082.
3. Kritski AL, Rodrigues de Jesus LS, Andrade MK, et al. Retreatment tuberculosis cases. Factors associated with drug resistance and adverse outcomes. Chest, 1997, 111(5):1162-1167.
4. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9):603-605.
5. Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version5.0.0[update February 2008]. The Cochrane Collaboration, 2008. Available at:www.cochrane-handbook.org.
6. 韓旻雁, 銀恭舉, 陳維清.中國人群鼻咽癌發病危險因素Meta分析.中國熱帶醫學, 2005, 5(07):1442-1443.
7. Hamling J, Lee P, Weitkunat R, et al. Facilitating meta-analyses by deriving relative effect and precision estimates for alternative comparisons from a set of estimates presented by exposure level or disease category. Stat Med, 2008, 27(7):954-970.
8. 李曉松.醫學統計學.北京:高等教育出版社, 2008:1-471.
9. 陳長生, 徐勇勇.第十四講如何進行meta分析.中華預防醫學雜志, 2003, 37(2):138-140.
10. 范玉美.首次復治肺結核病人療效影響的因素分析.江蘇:蘇州大學, 2006.
11. 黃勇. 2003-2007年阿壩州涂陽肺結核發現和治療分析.寄生蟲病與感染性疾病, 2008, 6(4):193-196.
12. 唐恒發. 213例復治涂陽肺結核病例轉歸的影響因素分析.安徽預防醫學雜志, 2008, 14(4):250-252.
13. 范冀緩, 謝艷光, 何廣學, 等.黑龍江省耐藥監測項目中肺結核治療失敗的原因分析.中國防癆雜志, 2009, 31(12):681-685.
14. 王靜, 羅萍, 洪峰, 等. 223例復治涂陽肺結核患者治療現狀分析.中國防癆雜志, 2010, 32(7):376-379.
15. 杜建, 徐彩紅, 楊應周, 等.標準短程化療方案治療初治復治肺結核失敗原因分析.中國病原生物學雜志, 2012, 7(7):523-526.
16. 李鵬鵬, 張宏蘭, 孫凱成. 352例復治涂陽肺結核患者治療效果分析.臨床肺科雜志, 2012, 17(4):669-670.
17. 段瓊紅, 陳聰, 張正斌, 等.武漢市首次復治涂陽肺結核治療結局及影響因素分析.中國防癆雜志, 2013, 35(10):788-792.
18. 張志進. 416例復治涂陽肺結核患者治療轉歸及影響因素分析.中外健康文摘, 2013, (38):872-73.
19. 孫釗, 孟煒麗, 李慧穎, 等.標準復治方案對復治菌陽肺結核患者的療效觀察.北京醫學, 2014, 36(6):491-492.
20. 杜建, 高微微, 馬艷, 等.優化方案和規范化方案對復治肺結核合并糖尿病的療效.中華結核和呼吸雜志, 2015, 38(12):886-891.
21. 胡潔.嘉興市結核病耐藥情況及復治肺結核患者治療方案比較的研究.浙江:浙江大學, 2015.
22. 李莉, 孫建勝, 張海清, 等.耐多藥結核病成因及治療效果的分析.預防醫學論壇, 2015, 21(8):568-572.
23. Alisjahbana B, Sahiratmadja E, Nelwan EJ, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis, 2007, 45(4):428-435.
24. Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus:convergence of two epidemics. Lancet Infect Dis, 2009, 9(12):737-746.
25. Dooley KE, Tang T, Golub JE, et al. Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis. Am J Trop Med Hyg, 2009, 80(4):634-639.
26. Baker MA, Harries AD, Jeon CY, et al. The impact of diabetes on tuberculosis treatment outcomes:a systematic review. BMC Med, 2011, 9(81):1-15.
27. 何權瀛, 張波.應高度重視免疫功能低下患者的肺部感染.中華結核和呼吸雜志, 2012, 33(10):721-722.
28. Nijland HM, Ruslami R, Stalenhoef JE, et al. Exposure to rifampicin is strongly reduced in patients with tuberculosis and type 2 diabetes. Clin Infect Dis, 2006, 43(7):848-854.
29. Lenjisa J. Assessment of Tuberculosis Retreatment Case Rate and Its Treatment Outcomes at Adama Hospital Medical College, East Showa, Ethiopia. J Steroids Horm Sci, 2015, 06(1):1-6.
30. Jones-Ló pez EC, Ayakaka I, Levin J, et al. Effectiveness of the standard WHO recommended retreatment regimen (category II) for tuberculosis in Kampala, Uganda:a prospective cohort study. PLoS Med, 2011, 8(3):e1000427.
31. Mpagama SG, Lekule IA, Mbuya AW, et al. The Influence of Mining and Human Immunodeficiency Virus Infection Among Patients Admitted for Retreatment of Tuberculosis in Northern Tanzania. Am J Trop Med Hyg, 2015, 93(2):212-215.
32. Matthys F, Rigouts L, Sizaire V, et al. Outcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis. PLoS One, 2009, 4(11):e7954.
33. Kritski AL, Rodrigues De Jesus LS, Andrade MK, et al. Retreatment tuberculosis cases. Factors associated with drug resistance and adverse outcomes. Chest, 1997, 111(5):1162-1167.
34. Espinal MA, Kim SJ, Suarez PG, et al. Standard short-course chemotherapy for drug-resistant tuberculosis:treatment outcomes in 6 countries. JAMA, 2000, 283(19):2537-2545.
35. He GX, Xie YG, Wang LX, et al. Follow-up of patients with multidrug resistant tuberculosis four years after standardized first-line drug treatment. PLoS One, 2010, 5(5):e10799.
36. Green E, Obi CL, Nchabeleng M, et al. Drug-susceptibility patterns of Mycobacterium tuberculosis in Mpumalanga province, South Africa:possible guiding design of retreatment regimen. J Health Popul Nutr, 2010, 28(1):7-13.
37. Mak A, Thomas A, Del Granado M, et al. Influence of multidrug resistance on tuberculosis treatment outcomes with standardized regimens. Am J Respir Crit Care Med, 2008, 178(3):306-312.
38. Ogbera AO, Kapur A, Abdur-Razzaq H, et al. Clinical profile of diabetes mellitus in tuberculosis. BMJ Open Diabetes Res Care, 2015, 3(1):e000112.
39. Tabarsi P, Chitsaz E, Tabatabaei V, et al. Revised Category II regimen as an alternative strategy for retreatment of Category I regimen failure and irregular treatment cases. Am J Ther, 2011, 18(5):343-349.
40. Takarinda KC, Harries AD, Srinath S, et al. Treatment outcomes of adult patients with recurrent tuberculosis in relation to HIV status in Zimbabwe:a retrospective record review. BMC Public Health, 2011, 12(12):124.
41. World Health Organization. Global Tuberculosis Report 2013, Geneva:WHO.
42. Han LL, Sloutsky A, Canales R, et al. Acquisition of drug resistance in multidrug-resistant Mycobacterium tuberculosis during directly observed empiric retreatment with standardized regimens. Int J Tuberc Lung Dis, 2005, 9(7):818-821.
43. Faustini A, Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe:a systematic review. Thorax, 2006, 61(2):158-163.
44. Denholm J. The most recent report from the World Health Organization found that, worldwide, approximately 5% of new tuberculosis cases are caused by multidrug-resistant strains (MDR TB). J Travel Med, 2010, 17(3):216.
45. Pieroni M, Tipparaju SK, Lun S, et al. Pyrido[1, 2-a]benzimidazole-based agents active against tuberculosis(TB), multidrug-resistant(MDR) TB and extensively drug-resistant(XDR) TB. ChemMedChem, 2011, 6(2):334-342.
46. Prammananan T, Chaiprasert A, Leechawengwongs M. In vitro activity of linezolid against multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant (XDR)-TB isolates. Int J Antimicrob Agents, 2009, 33(2):190-191.

Chinese Journal of Evidence-Based Medicine

Risk Factors of Retreatment Pulmonary Tuberculosis Patients with Unfavorable Treatment Outcome in China: A Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content