HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Faustini, A. Articles by Perucci, C. A. Search for Related Content PubMed PubMed Citation Articles by Faustini, A. Articles by Perucci, C. A.

Tuberculosis treatment outcomes in Europe: a systematic review

¹ Dept of Epidemiology, Local Health Agency Rome E, Rome, Italy, and ² Dept of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK.

CORRESPONDENCE: A. Faustini, Dept of Epidemiology RME, v. S. Costanza n. 53, 00198 Rome, Italy. Fax: 39 0683060463. E-mail: faustini@asplazio.it

Keywords: Meta-analysis, surveillance, surveys, systematic review, tuberculosis treatment outcomes

Received: September 3, 2004
Accepted February 7, 2005

In order to facilitate the control of tuberculosis (TB), the World Health Organization (WHO) has defined a standardised short-course chemotherapy and a strategy, directly observed therapy. In 2000, WHO surveillance of TB treatments in Europe recorded a successful outcome rate of 77%. The aim of this report is to estimate treatment outcomes in European countries based on published studies and to identify their determinants.

A systematic review was conducted of published reports of TB treatment outcomes in Europe. Meta-analysis, meta-regression and subgrouping were used to pool treatment outcomes and analyse associations with mean age, sex, immigration status and multidrug resistance.

Of the 197 articles identified in the search, 26 were eligible for the review; 74.4% of outcomes were successful, 12.3% were unsuccessful and 6.8% of patients died. Heterogeneity was high for all outcomes. National estimates were possible for six countries. Multidrug resistance was inversely associated with successful outcome, which were fewer in populations with >9% multidrug-resistant TB, and in patients aged <44 yrs.

Successful tuberculosis treatment outcomes were below the 85% threshold suggested by the World Health Organization. There was an inverse association with levels of multidrug-resistant tuberculosis. The unexplained heterogeneity between the studies for unsuccessful outcomes seems to be due to differing interpretations given to World Health Organization definitions.

This article has been cited by other articles:

				I C Ditah, M Reacher, C Palmer, J M Watson, J Innes, M E Kruijshaar, H N Luma, and I Abubakar Monitoring tuberculosis treatment outcome: analysis of national surveillance data from a clinical perspective Thorax, May 1, 2008; 63(5): 440 - 446. [Abstract] [Full Text] [PDF]

				D. Antoine, C. E French, J. Jones, and J. M Watson Tuberculosis treatment outcome monitoring in England, Wales and Northern Ireland for cases reported in 2001 J Epidemiol Community Health, April 1, 2007; 61(4): 302 - 307. [Abstract] [Full Text] [PDF]

				Y. S. Kwon, W.-J. Koh, G. Y. Suh, M. P. Chung, H. Kim, and O. J. Kwon Hepatitis C Virus Infection and Hepatotoxicity During Antituberculosis Chemotherapy Chest, March 1, 2007; 131(3): 803 - 808. [Abstract] [Full Text] [PDF]