Evaluation of demographic and clinical characteristics of patients being treated for tuberculosis and factors affecting the success of treatment in patients with pulmonary tuberculosis

Objective: Among the infectious diseases, tuberculosis (TB) is still among the diseases that affect many people and cause death in the world. It is one of the 10 most deadly diseases in the world. According to the data of the World Health Organization (WHO), 10.6 million new patients emerged worldwide in 2021 and 1.6 million people died. According to WHO and Ministry of Health data, the success of treatment in all cases in our country is around 85%. Many conditions that affect the success of treatment have been described. Age, gender, comorbid conditions such as DM and HIV, delay in diagnosis, lung involvement, prevalence, multi-drug resistance status, number of drugs and duration of treatment, smoking, alcohol and substance use, drug side effects, low socio-economic status and education level. The aim of this study is to evaluate the demographic, clinical and laboratory data of tuberculosis cases diagnosed, treated and followed up in Rize province, to determine the risk situations and to determine the factors affecting the treatment success rate and treatment failure in patients with pulmonary tuberculosis. Materials and Methods: Our study consists of tuberculosis patients who were diagnosed and treated at Rize Tuberculosis Dispensary and Recep Tayyip Erdoğan University Training and Research Hospital (RTEU EAH) between 01.01.2018 and 31.01.2021. It is a retrospective observational study. To collect the necessary data for the study, a computer-based data system, in which RTUE EAH patient records are kept, and Rize Tuberculosis Dispensary patient file archive were used. With the data obtained from the data system, demographic data such as age, gender, comorbid conditions such as DM and HIV, smoking and substance use, drug side effects, low socio-economic status, and education level were obtained. Chest X-ray findings and Computed Thoracic Tomography findings, if taken, were determined in the file scan of the patients. In addition, the location of tuberculosis involvement, duration of treatment, treatment success, multi-drug resistance and number of drugs, biochemical and microbiological examinations were recorded. xv Results: The median age (min-max) of 171 patients included in the study was found to be 54 (18-88). 107 (62.6%) of the patients were male and 64 (37.4%) were female. The most common comorbid diseases were diabetes mellitus 43.9% and hypertension 31.5%. Pulmonary tuberculosis was detected in 117 (68.4%) cases and extrapulmonary tuberculosis was found in 54 (31.6%) cases. The proportion of women with extrapulmonary tuberculosis was higher. While treatment success was achieved in 108 (92.3%) of 117 patients with pulmonary tuberculosis, treatment failure was detected in 9 (7.7%) patients. Age, male sex ratio, HT and COPD ratio, alcohol and cigarette use rates were found to be higher in the treatment unsuccessful patients. In addition, the presence of cavities and diffuse involvement were found to be more common in the treatment-failed group. While sedimentation, CRP, leukocyte, neutrophil, and eosinophil values at the time of diagnosis were higher in cases with unsuccessful treatment; Hemoglobin, hematocrit and thrombocyte values were found to be lower. Conclusion: Treatment success in patients with pulmonary tuberculosis was found to be high. Advanced age, male gender, alcohol use, presence of hypertension and COPD, hemoptysis, presence of cavity in lung imaging and extensive involvement were determined as factors causing treatment failure. Keywords: Pulmonary tuberculosis, Treatment success