期刊
BMC INFECTIOUS DISEASES
卷 18, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12879-017-2933-4
关键词
Tuberculosis recurrence; Tuberculosis reinfection; Tuberculosis relapse; Mycobacterium tuberculosis; Tuberculosis; TB
资金
- BBSRC [BB/K000330/1]
- Dowager Countess Eleanor Peel Trust
- National Institute for Health Research (NIHR Post-Doctoral Fellowship) [PDF-2015-08-102]
- BBSRC [BB/K000330/1] Funding Source: UKRI
- Biotechnology and Biological Sciences Research Council [BB/K000330/1] Funding Source: researchfish
- National Institute for Health Research [PDF-2015-08-102] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [PDF-2015-08-102] Funding Source: National Institutes of Health Research (NIHR)
Background: Tuberculosis (TB) recurrence represents a challenge to control programs. In low incidence countries, the prevailing risk factors leading to recurrence are poorly characterised. Methods: We conducted a nested case-control study using the Leicester TB service TBIT database. Cases were identified from database notifications between 1994 and 2014. Controls had one episode and were matched to cases on a ratio of two to one by the date of notification. Multiple imputation was used to account for missing data. Multivariate conditional logistic regression analysis was employed to identify clinical, sociodemographic and TB specific risk factors for recurrence. Results: From a cohort of 4628 patients, 82 TB recurrences occurred (1.8%). Nineteen of 82 patients had paired isolates with MIRU-VNTR strain type profiles available, of which 84% were relapses and 16% reinfections. On multivariate analysis, smoking (OR 3.8; p = 0.04), grade 3/4 adverse drug reactions (OR 5.6; p = 0.02), ethnicity 'Indian subcontinent' (OR 8.5; p = <0.01), ethnicity 'other' (OR 31.2; p = 0.01) and receipt of immunosuppressants (OR 6.8; p = <0.01) were independent predictors of TB recurrence. Conclusions: Within this UK setting, the rate of TB recurrence was low, predominantly due to relapse. The identification of an elevated recurrence risk amongst the ethnic group contributing most cases to the national TB burden presents an opportunity to improve individual and population health.
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