Medical characteristics and tuberculosis treatment outcomes in an urban tertiary hospital, Thailand.

ABSTRACT

The purpose of this study was to describe medical characteristics and assess treatment outcomes at a respiratory clinic, tertiary hospital, Bangkok, Thailand. One hundred seventy-seven patients diagnosed as having any type of TB and having taken anti-TB drugs for one month were included in the study. The patients were interviewed the end of the first month and their medical files were reviewed at the end of treatment to obtained the treatment outcome. Descriptive statistics and chi-square test were used in the data analyses. Of the total of 177 patients, 33.3% were new smear-positive, 19.2% were new smear-negative, 18.1% were extra-pulmonary TB, and 29.4% were other. The prevalence of TB/HIV co-infection was 33% (18 of 54). Resistance to at least one anti-TB drug was 31.6% (6 of 19). Due to high treatment default rates, treatment completion rates were low, 64.4% in new smear-positives, 61.8% in new smear-negatives, 71.9% in extra-pulmonary TB, and 46.2% in other. Treatment default rates significantly differed among the four types of TB (chi2 = 8.3, p = .04). The findings indicate a high proportion of extra-pulmonary TB, high prevalence of TB/HIV coinfection, and low treatment completion in urban TB patients at the tertiary hospital. Interventions are needed to integrate the strengths of the tertiary hospital regarding the availability of chest specialists and advance diagnostic tools into the other levels of health service to improve treatment outcomes in urban populations.