A multilevel analysis on spatiotemporal and individual-level determinants of tuberculosis treatment failure in China

By exploring the factors that influence treatment failure in tuberculosis, the study aimed to provide references for the treatment and management of tuberculosis. The study data were derived from the National Tuberculosis Specialized Reporting System. Univariate analysis was used to test individual characteristic variables related to tuberculosis treatment failure. A three-level model was conducted to estimate the risk of tuberculosis treatment failure from both temporal and spatial levels, as well as from the individual level. Analysis revealed that demographic characteristics, such as older age (50 years and above) and male sex, were independent risk factors for tuberculosis treatment failure. Among diagnostic and treatment factors, the type of tuberculosis diagnosis contributed the most to treatment failure, followed by positive result for Mycobacterium tuberculosis detection, a history of previous drug therapy and treatment delays of more than one month. After excluding the effects of individual factors, there was also a spatiotemporal effect of treatment failure. Besides the effect of the individual factors, macro factors such as the socioeconomic development level and the quality of tuberculosis management might also play an important role in treatment failure. The study on the spatiotemporal effect provided a reference for objectively evaluating the quality of work in different regions.