Abstract:

Objective To understand the factors affecting the treatment outcomes of patients with subclinical tuberculosis in China for evidence in prevention of the infection and treatment of such patients in the future. Methods The data of subclinical tuberculosis patients diagnosed by designated tuberculosis medical institutions at all levels in China were obtained from 2021 to 2022 via the Tuberculosis Management Information System of China Information System for Disease Control and Prevention. The case information consisted of demographic characteristics, clinical pictures and medication history, and was descriptively analyzed concerning the characteristics in population distribution. Binary logistic regression model was used to analyze the factors affecting treatment outcomes. Results Between 2021 and 2022, a total of 3 804 patients were included, in whom 2 587 (68.0%) were males. 1 232 (32.4%) patients aged from 45 to 64 years, and 2 161 (56.8%) were farmers. 3 445 (90.6%) patients were local infection, and 3 625 (95.3%) were new patients. 2 758 (72.5%) patients were identified in referral and follow-up, and 3 743 (98.4%) were HIV negative. According to the outcome, 3 558 cases (93.5%) had successful treatment and 246 cases (6.5%) had poor outcome. Logistic regression analysis showed that the risk factors for medication outcomes involved in patients aged 45-64 years old (OR=2.264, 95% CI: 1.244-4.119) or ≥65 years old (OR=4.538, 95%CI: 2.521-8.169), patients with HIV positive (OR=2.443, 95%CI: 1.090-5.476), or with comorbidities (OR=1.761, 95%CI: 1.305-2.378) and those with positive pathogen findings (OR=2.187, 95%CI: 1.548-3.087), patients undergone initial treatment regimens with 2HRZE/10HRE (OR=4.466, 95%CI: 3.009-6.629), 2HRZE/7-10HRE (OR=2.240, 95%CI: 1.262-3.975), or other sensitive regimens (OR=1.802, 95%CI: 1.228-2.645). Conclusion Subclinical tuberculosis patients were mainly middle-aged or elderly male farmers, and local infections. The patients were generally passively identified in referral and follow-up. Poor treatment outcomes may occur in patients aged ≥45 years, patients with HIV positive, or comorbidities, and those with positive pathogen results as well as failed use of standard medication regimen in patients undergone the initial treatment of tuberculosis. Therefore, it is necessary to further expand active detection of potential tuberculosis patients in the elderly population and those in rural areas, as well as further standardize the diagnosis and treatment of tuberculosis patients in order to early identify the subclinical tuberculosis patients and improve successful medication.

Key words: Subclinical tuberculosis, Treatment outcomes, Influencing factors