Epidemiology of Recurrent Pulmonary Tuberculosis in Henan Province, China: Observational study (Preprint)

BACKGROUND A subset of patients who complete standard treatment for pulmonary tuberculosis (PTB) develop TB recurrence. OBJECTIVE This study characterized the epidemiological features of recurrent PTB patients to estimate recurrence probability associated with different smear test results and examine risk factors associated with recurrence. METHODS Using 2005-2018 provincial surveillance data from Henan, China, we described the epidemiologic and bacteriological features of recurrent PTB. The Kaplan-Meier method was used to estimate hazards of recurrent PTB and calculate PTB recurrence probability and risk factors. RESULTS The number of PTB has been decreasing significantly for 14 years, however, the number of recurrent cases dramatically increased from 5 in 2005 to 2,234 in 2018. A total of 7,143 (1·5%) patients had recurrence, and 21·1% tested bacteriological positive on both laboratory tests (positive–positive), and 34·9% tested negative-negative. The first and second recurrence probability were increasing from 0.2% and 2.0% at 10 months to 0.6% and 5.2% at 40 months after the completion of treatment, respectively. Patients with different gender, age, infection type, treatment time and region have different recurrent probability and risk. CONCLUSIONS The increase of recurrent cases has become one of the new and emphasized stumbling block preventing China from achieving WHO’s target of eradicating TB and should actively enact measures to control based on its epidemiological characteristics.