OUTCOME OF FIRST-LINE TUBERCULOSIS TREATMENT IN MIGRANTS FROM VIETNAM

SETTING: Screening and treatment of tuberculosis in prospective migran ts from Vietnam, in the framework of the Orderly Departure Programme. OBJECTIVE: 1) To describe the outcome of first-line tuberculosis treat ment, and 2) to investigate the role of prognostic factors on treatmen t outcome. DESIGN: Cohort of consecutive smear-positive patients ident ified by screening before departure, and followed up until cure or fai lure, for a maximum of two years. RESULTS: Seven hundred and twenty-ni ne patients were consecutively diagnosed with infectious tuberculosis. Patients received directly observed treatment with rifampicin, isonia zid, ethambutol and pyrazinamide for a minimum of 6 months, or until s putum conversion was maintained for 6 consecutive months. The cumulati ve percentage of cure with first-line treatment was 50.2% (SE = 2%) at 7 months, and 92.8% (SE = 2%) at 24 months. Young patients without ca vities achieved the highest percentage of cure. Stratified testing con firmed the negative effect on the chance of cure of age >45 years (P < 0.001), and cavities (P ( 0.001), while the effect of previous treatm ent was not significant (P = 0.105).CONCLUSIONS: While the overall cur e rate was satisfactory, older patients and those with cavities requir ed prolonged treatment and reached a less satisfactory level of cure.