Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry

Int J Tuberc Lung Dis. 2015 Jul;19(7):764-71. doi: 10.5588/ijtld.14.0767.

Abstract

Objectives: To determine treatment outcomes and associated predictors of all patients registered in 2012 with the Malaysian National Tuberculosis (TB) Surveillance Registry.

Methods: Sociodemographic and clinical data were analysed. Unfavourable outcomes included treatment failure, transferred out and lost to follow-up, treatment defaulters, those not evaluated and all-cause mortality.

Results: In total, 21 582 patients were registered. The mean age was 42.36 ± 17.77 years, and 14.2% were non-Malaysians. The majority were new cases (93.6%). One fifth (21.5%) had unfavourable outcomes; of these, 46% died, 49% transferred out or defaulted and 1% failed treatment. Predictors of unfavourable outcomes were older age, male sex, foreign citizenship, lower education, no bacille Calmette-Guérin (BCG) vaccination scar, treatment in tertiary settings, smoking, previous anti-tuberculosis treatment, human immunodeficiency virus infection, not receiving directly observed treatment, advanced chest radiography findings, multidrug-resistant TB (MDR-TB) and extra-pulmonary TB. For all-cause mortality, predictors were similar except for rural dwelling and nationality (higher mortality among locals). Absence of BCG scar, previous treatment for TB and MDR-TB were not found to be predictors of all-cause mortality. Indigenous populations in East Malaysia had lower rates of unfavourable treatment outcomes.

Conclusions: One fifth of TB patients had unfavourable outcomes. Intervention strategies should target those at increased risk of unfavourable outcomes and all-cause mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Child
  • Child, Preschool
  • Diabetes Mellitus / epidemiology*
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Lost to Follow-Up
  • Malaysia / epidemiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Treatment Failure
  • Treatment Outcome
  • Tuberculosis / classification*
  • Tuberculosis / complications*
  • Tuberculosis / mortality*
  • Young Adult