[Cohort analysis for treatment outcomes TB pulmonary cases bacteriologically confirmed in Poland]

In Poland since 1986 system of treatment outcomes monitoring (TOM) of all confirmed pulmonary TB (PTB) cases has been introduced. This system is based on the Central Tuberculosis Register TB detected and registered in given year from the whole network tuberculosis and lung diseases dispensaries in the country--/ 400 disp. in 2004 yr/. The aim of the study was to asses treatment results of PTB confirmed cases registered in 2003 and in the period 2001-2003. In 2003 5558 cases were registered, The treatment outcomes were assessed according to WHO/Euro TB-categories after 12 months after start of treatment as PTB: cured--67.8%; completed--10.4% (success ratio--77.8%); failed--1.5%, died--5.1% (from TB--2.1%); defaulted--7.6%, still on treatment--0.6%; transferred--1.9%. and unknown--5.5% all registered PTB cases. In period 2001-2003 proportion patients with success of treatment was stable. In 2003 proportion of patients with success of treatment was significantly higher in a groups of new cases--83.7 than in patients with relapses--73.9%; among women--85.4% than in men--80.9%. Among PTB cases smear positive success ratio--81.3 was lower than among PTB cases culture positive--84.0. Among patients with diabetes and alcohol abuse the success of treatment was significantly lower than more patients without these diseases/habit. Alcoholics three times more frequently defaulted treatment than patients without this habit.

The improvement of treatment outcomes is impossible without generalize directly observed treatment in all patients in continuation phase of treatment.