Tuberculosis relapse is more common than reinfection in Beijing, China

Abstract

Background: Recurrent tuberculosis (TB) is a major health problem in countries with a high TB burden. It is very necessary to elucidate the situation of recurrent TB in Beijing, capital of China. Objective: To determine the proportion of recurrent tuberculosis (TB) cases and to identify relapsed or reinfected cases, as well as risk factors associated with recurrence in Beijing. Methods: We conducted a retrospective study that included all TB cases in Beijing that were successfully treated from 2013 to 2015. Recurrence due to relapse or reinfection was determined using the variable number of tandem repeats (VNTR) method. Risk factors associated with recurrence were analysed. Results: Tuberculosis recurred in 275 of the 4043 successfully treated TB patients, giving a recurrence rate of 6.8% (275/ 4043). 190 of the 275 cases were culture positive in both instances, and genotyping results for both episodes were available for 58 of these patients. The cultured isolates from 40 of the 58 recurrent cases (69%) had identical genotypic patterns in both episodes, indicating a relapse. 31% (18/58) had different genotypes, indicating reinfection by a new strain and suggested recent transmission. Those people in the 30-59 age group (p < .001), and those retreated for pulmonary TB (p < .001) were more likely to have TB recurrence. Conclusion: Our results indicate that relapse was more common than reinfection in recurrent TB cases in Beijing from 2013 to 2015. Age and retreatment were found to be risk factors for TB recurrence.

Recurrent pulmonary tuberculosis after treatment success: a population-based retrospective study in China

“…The results of this retrospective study found that the recurrence rate after successful treatment was lower than that reported in areas with high TB incidence [7]. Yi Liu et al reported a TB recurrence rate of 6.8% (275/4,043) in Beijing, China, with a 3-year follow-up period from 2013 to 2015 [8]. Additionally, Suzanne Verver et al reported a 14% (61/447) recurrence rate after successful treatment, with a 5-year follow-up period in Cape Town, South Africa [9].…”

Tuberculosis recurrence over a 7-year follow-up period in successfully treated patients in a routine program setting in China: a prospective longitudinal study

“…[18][19][20][21] Previous studies reported that 58.2-69.0% of recurrent TB in China were resulted from relapse of the original M. tuberculosis strain rather than from reinfection with a new strain. [22][23] However, we are not able to comment on this as we did not test those who represented with TB to establish if it was relapse or reinfection. As relapse usually occurs because of inadequate treatment, 5 and may reflect the quality of program for certain treatment regimens and TB programs need to pay attention to recurrence rates in those people cured or successfully completing treatment.…”

Internal wars in history: Triggered by natural disasters or socio-ecological catastrophes?

“…Epidemics data were obtained and aggregated from the Collection of Meteorological Records in China over the Past Three Thousands Years (Zhang, 2004), Historical Records of Infectious Diseases in China (Li, 2004), and Epidemic Records in Historical China (Zhang, 2007). The three datasets are tabulated from official dynastic histories and local chronicles.…”