Surveillance of tuberculosis treatment outcomes of Singapore citizens and permanent residents, 2002-2011

摘要

SETTING: Singapore, which had a tuberculosis (TB) incidence rate of 41 per 100 000 resident population in 2011. OBJECTIVE: To report the outcomes of Singapore citizens and permanent residents treated for TB from 2002 to 2011. METHODS: A computerised treatment surveillance module (TSM) was launched in 2001 to track the progress and outcome of TB patients nationally. Physicians were required to submit an electronic or paper return for every patient at each clinic visit. Treatment adherence, drugs prescribed, treatment delivery mode and final outcome,specified as 'completed treatment', 'lost to followup', 'death', 'transferred out', 'permanent cessation of treatment' and 'still on treatmento final outcome', were captured. Quarterly cohort outcomes at 12-15 months after starting treatment were combined to generate annual treatment outcomes. RESULTS: Treatment completion rates increased from 73.4% to 82.8%. The proportion of patients lost to follow-up decreased from 3.4% to 1.7%, while that of patients still on treatment or with no final outcome decreased from 10.5% to 4.4%. The death rate ranged between 10.2% and 11.7%; the majority were not attributed to TB. CONCLUSION: TB treatment completion among Singapore citizens and permanent residents has improved since 2002 as the likely result of the TSM and other initiatives introduced over the past decade.