PREDICTORS OF TUBERCULOSIS RELAPSE IN PASIR PUTEH DISTRICT, KELANTAN: A CASE-CONTROL STUDY.
Background: Tuberculosis relapse is one of Malaysia’s public health concerns. Studying relapse of tuberculosis is a convenient way to evaluate the effectiveness of tuberculosis control programs and identify vulnerable patients. This study aimed to estimate the prevalence of tuberculosis relapse and determine its associated factors in Pasir Puteh district.
Materials and Methods: This study was a case control study between the relapsed and non-relapsed group conducted in the district of Pasir Puteh, Kelantan. All notified cases that fulfilled the inclusion and exclusion criteria from 1st January 2014 to 31st December 2018 were included in the study. Descriptive statistics, simple and multiple logistic regressions were used for data analysis.
Result: From 2014 until 2018, there were 454 tuberculosis cases registered in Pasir Puteh district. The prevalence of tuberculosis relapse cases within the five-year period was 8.4% (95%CI: 0.06, 0.11). Majority of TB relapse patients were adult group, male, had secondary level of education, and unemployed. By clinical factors, most of tuberculosis relapse patients were non-diabetic, cigarette smokers, HIV negative, had pulmonary form of tuberculosis, and had minimal lesion on chest radiographic findings. Diabetic patients and cigarette smokers were the significant factors associated with tuberculosis relapse in Pasir Puteh district with an adjusted odds ratio (AOR) of 2.98 (95%CI:1.23, 7.26; p=0.016) and 4.27 (95%CI:1.54, 11.85; p=0.005), respectively.
Conclusion: In conclusion, diabetic patients and cigarette smokers were more likely to develop tuberculosis relapse. Thus, the identified risk factors were useful for diagnosis and in planning for screening and intervention programs.
Keywords: tuberculosis, relapse, associated factors, diabetes, cigarette smoking, Malaysia.